[Thrombocytes as an indicator of activity in Crohn's disease treated with total parenteral and/or enteral nutrition]
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Platelet count can indicate Crohn's disease (CD) activity. A significant drop in thrombocytes was observed after 3 weeks of nutritional therapy, correlating with improved patient status and reduced inflammation markers.
Area of Science:
- Gastroenterology
- Hematology
- Clinical Nutrition
Context:
- Inflammatory bowel disease, specifically Crohn's disease (CD), is often linked to elevated platelet counts.
- Patients with active CD frequently experience malnutrition, necessitating nutritional support like total parenteral/enteral nutrition (TP/EN).
Purpose:
- To evaluate the utility of thrombocyte (platelet) count in assessing disease activity in Crohn's disease patients undergoing nutritional therapy.
- To investigate the correlation between platelet counts and nutritional parameters and inflammatory markers during TP/EN.
Summary:
- This study monitored platelet counts in 19 malnourished Crohn's disease patients receiving TP/EN for 3 weeks.
- A significant decrease in mean platelet count was observed after therapy (472 to 354 x 10^9/L, p < 0.01).
- Platelet counts correlated with nutritional markers (prealbumin, haptoglobin, alpha 1-orosomucoid) and C-reactive protein.
Impact:
- Thrombocyte count serves as a valuable indicator for monitoring Crohn's disease activity during nutritional interventions.
- A reduction in platelet count during TP/EN is associated with improved clinical status, enhanced nutritional parameters, and decreased inflammation.
Unlabelled:
Inflammatory bowel disease can be associated with increased platelet count. Aim of our study was focused on assessing thrombocyte count in evaluation of the activity in Crohn's disease (CD). The study included a total of 19 patients [6 men, 13 women (aged 18-57 years, mean 33, median 28]. All patients were malnourished in active stage of the disease on total parenteral and/or enteral nutrition (TP/EN). Thrombocytes were estimated at the beginning and after 3 weeks of TP/EN in venous blood sample using automatic analyser Coulter Counter JT3 (normal range: 130-380.10(9)/l). Serum prealbumin, transferrin, haptoglobin, alpha 1-orosomucoid and C-reactive protein were measured simultaneously. Thrombocytes count below 400.10(9)/l was found only in 1/19 at the beginning and in 7/19 patients in the end of the study. After 3 weeks of TP/EN a significant platelet count fall was found (mean +/- sd: 472 +/- 98 vs. 354 +/- 110, p < 0.01). A correlation was found between thrombocytes and serum prealbumin (r = -0.3871, p < 0.05), haptoglobin (r = 0.5247, p < 0.001), alpha 1-orosomucoid (r = 0.4857, p < 0.01) a C-reactive protein (r = 0.4354, p < 0.01).
Conclusion:
Thrombocyte count helped in the assessing of disease activity in CD on 3-week-TP/EN. Improvement of clinical status, increase of nutritional parameters and decrease of positive acute phase reactants were associated with a fall of platelet count in 15/19 patients.