Tissue immunoglobulins and early recurrence in Crohn's disease

The early recurrence rates following surgical treatment of Crohn's disease are distressingly high. In clinical studies in which an attempt is made to correlate duration, severity and extent of disease, the prediction as to which patients are prone to have the disease recur was not successful. The immunoglobulin G value is elevated in the diseased portion and in 50 per cent of the normal appearing margins of resected intestine from patients with Crohn's disease. Half of the patients with immunoglobulin G values above 18 milligrams per gram of dry weight at the margins had recurrences at the suture line within three years. The immunoglobulin G concentrations do not correlate with steroid treatment, duration of symptoms, extent of disease, presence of epithelioid granulomas or previous recurrent disease. Immunoglobulin A and immunoglobulin M values are not helpful in predicting recurrences. Elevation of immunoglobulin G values at the resection margins appears to be a reliable indicator of early recurrence in patients with Crohn's disease.