Deep ulcers are associated with increased C-reactive protein in active ulcerative colitis.

Area of Science:

• Gastroenterology
• Inflammatory Bowel Disease Research
• Clinical Biomarker Studies

Background:

• C-reactive protein (CRP) is a key indicator for diagnosing and predicting treatment response in severe ulcerative colitis (UC).
• Understanding the relationship between CRP levels and ulcer depth is crucial for effective patient management.

Purpose of the Study:

• To investigate the correlation between elevated C-reactive protein (CRP) levels and the presence of deep ulcers in patients with ulcerative colitis (UC).

Main Methods:

• A multicenter prospective cohort study and a retrospective colectomy cohort were utilized, enrolling patients with active UC between 2012 and 2019.
• Data analysis focused on correlating CRP levels (categorized as <30 mg/L, 30-100 mg/L, and >100 mg/L) with the presence of deep ulcers.

Main Results:

• In the prospective cohort (41 patients), deep ulcers were found in 22% of patients, with a significant association observed between higher CRP levels and deep ulcers (p=0.006).
• The retrospective cohort (46 patients) showed a similar trend, with 67% having deep ulcers and a strong correlation with elevated CRP (p=0.001).
• A CRP level >100 mg/L demonstrated a high positive predictive value (80% and 100%) for deep ulcers in both cohorts.

Conclusions:

• Elevated C-reactive protein (CRP) serves as a reliable surrogate marker for identifying deep ulcers in ulcerative colitis (UC) patients.
• Both high CRP levels and the presence of deep ulcers are significant factors that may influence the selection of medical therapy for acute severe UC.