Slight Increases in the Disease Activity Index and Platelet Count Imply the Presence of Active Intestinal Lesions in C-reactive Protein-negative Crohn's Disease Patients
Objective Although the serum C-reactive protein (CRP) level may, to some extent, predict the disease activity in patients with Crohn's disease (CD), it is not always elevated during periods of disease activity. This study aimed to identify factors predicting the presence of active intestinal le...
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| Veröffentlicht in: | Internal Medicine 2014, Vol.53(17), pp.1905-1911 |
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| creator | Nakarai, Asuka Kato, Jun Hiraoka, Sakiko Inokuchi, Toshihiro Takei, Daisuke Morito, Yuki Akita, Mitsuhiro Takahashi, Sakuma Hori, Keisuke Harada, Keita Okada, Hiroyuki Yamamoto, Kazuhide |
| description | Objective Although the serum C-reactive protein (CRP) level may, to some extent, predict the disease activity in patients with Crohn's disease (CD), it is not always elevated during periods of disease activity. This study aimed to identify factors predicting the presence of active intestinal lesions in CD patients without an elevated CRP level. Methods CD patients in whom the presence or absence of active intestinal lesions was evaluated using endoscopic and/or radiologic modalities were divided into two groups based on a negative ( |
| doi_str_mv | 10.2169/internalmedicine.53.2627 |
| format | Article |
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This study aimed to identify factors predicting the presence of active intestinal lesions in CD patients without an elevated CRP level. Methods CD patients in whom the presence or absence of active intestinal lesions was evaluated using endoscopic and/or radiologic modalities were divided into two groups based on a negative (<3 mg/L) or positive (≥3 mg/L) CRP level. The correlations between the presence of active intestinal lesions and various clinical variables, including the Crohn's Disease Activity Index (CDAI), leukocyte and platelet counts and hemoglobin, serum albumin and CRP levels, were determined in the CRP-negative patients. Results Of the 128 patients examined, 70 had a negative CRP status, approximately half of whom had active intestinal lesions. The multivariate analysis revealed a CDAI of >100 and platelet count of >33×104 /μL to be significant predictive factors for the presence of active lesions in the CRP-negative patients [CDAI >100, odds ratio (OR) =5.55; 95% confidence interval (CI), 1.80-18.74, platelet count >33×104 /μL, OR =5.94; 95% CI, 1.34-28.87]. The sensitivity of fulfillment of either criterion for the presence of active intestinal lesions was 83%, while the specificity of fulfillment of both criteria was 94%. Conclusion A relatively low CDAI and platelet count were identified as predictive markers of the presence of active intestinal lesions in CRP-negative CD patients. These results suggest that symptoms and laboratory data should be evaluated very carefully in such patients.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.53.2627</identifier><identifier>PMID: 25175121</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>Adult ; Biomarkers - blood ; C-reactive protein ; C-Reactive Protein - metabolism ; Colon - diagnostic imaging ; Colon - pathology ; Colonoscopy ; Crohn Disease - blood ; Crohn Disease - diagnosis ; Crohn's disease ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Platelet Count ; Retrospective Studies ; Severity of Illness Index ; Tomography, X-Ray Computed ; Young Adult</subject><ispartof>Internal Medicine, 2014, Vol.53(17), pp.1905-1911</ispartof><rights>2014 by The Japanese Society of Internal Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c628t-2e7158d335af342502fcaac662bac714378e0b850895de667ab807c27bae02f83</citedby><cites>FETCH-LOGICAL-c628t-2e7158d335af342502fcaac662bac714378e0b850895de667ab807c27bae02f83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1883,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25175121$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nakarai, Asuka</creatorcontrib><creatorcontrib>Kato, Jun</creatorcontrib><creatorcontrib>Hiraoka, Sakiko</creatorcontrib><creatorcontrib>Inokuchi, Toshihiro</creatorcontrib><creatorcontrib>Takei, Daisuke</creatorcontrib><creatorcontrib>Morito, Yuki</creatorcontrib><creatorcontrib>Akita, Mitsuhiro</creatorcontrib><creatorcontrib>Takahashi, Sakuma</creatorcontrib><creatorcontrib>Hori, Keisuke</creatorcontrib><creatorcontrib>Harada, Keita</creatorcontrib><creatorcontrib>Okada, Hiroyuki</creatorcontrib><creatorcontrib>Yamamoto, Kazuhide</creatorcontrib><title>Slight Increases in the Disease Activity Index and Platelet Count Imply the Presence of Active Intestinal Lesions in C-reactive Protein-negative Crohn's Disease Patients</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>Objective Although the serum C-reactive protein (CRP) level may, to some extent, predict the disease activity in patients with Crohn's disease (CD), it is not always elevated during periods of disease activity. This study aimed to identify factors predicting the presence of active intestinal lesions in CD patients without an elevated CRP level. Methods CD patients in whom the presence or absence of active intestinal lesions was evaluated using endoscopic and/or radiologic modalities were divided into two groups based on a negative (<3 mg/L) or positive (≥3 mg/L) CRP level. The correlations between the presence of active intestinal lesions and various clinical variables, including the Crohn's Disease Activity Index (CDAI), leukocyte and platelet counts and hemoglobin, serum albumin and CRP levels, were determined in the CRP-negative patients. Results Of the 128 patients examined, 70 had a negative CRP status, approximately half of whom had active intestinal lesions. The multivariate analysis revealed a CDAI of >100 and platelet count of >33×104 /μL to be significant predictive factors for the presence of active lesions in the CRP-negative patients [CDAI >100, odds ratio (OR) =5.55; 95% confidence interval (CI), 1.80-18.74, platelet count >33×104 /μL, OR =5.94; 95% CI, 1.34-28.87]. The sensitivity of fulfillment of either criterion for the presence of active intestinal lesions was 83%, while the specificity of fulfillment of both criteria was 94%. Conclusion A relatively low CDAI and platelet count were identified as predictive markers of the presence of active intestinal lesions in CRP-negative CD patients. These results suggest that symptoms and laboratory data should be evaluated very carefully in such patients.</description><subject>Adult</subject><subject>Biomarkers - blood</subject><subject>C-reactive protein</subject><subject>C-Reactive Protein - metabolism</subject><subject>Colon - diagnostic imaging</subject><subject>Colon - pathology</subject><subject>Colonoscopy</subject><subject>Crohn Disease - blood</subject><subject>Crohn Disease - diagnosis</subject><subject>Crohn's disease</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Platelet Count</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Tomography, X-Ray Computed</subject><subject>Young Adult</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkd2O0zAQhS0EYsvCKyDfwU2Kf-LYuVyFv5UqbSXg2nKcSeuV6xTbXdFH4i1xm9ILxM1YnvnOnJEOQpiSJaNN-8GFDDEYv4PBWRdgKfiSNUw-QwvK67aSjIvnaEFaqipWyg16ldIjIVzJlr1EN0xQKSijC_T7m3ebbcb3wUYwCRJ2Aect4I8unf74zmb35PKxEAP8wiYMeO1NBg8Zd9MhFOlu749nzTpCgmABT-Osg6LKkLIrt-IVJDeFs0FXFbMZWMcpgwtVgI05N7o4bcO7dD1gXdoQcnqNXozGJ3hzeW_Rj8-fvndfq9XDl_vublXZhqlcMZBUqIFzYUZeM0HYaI2xTcN6YyWtuVRAeiWIasUATSNNr4i0TPYGCqv4LXo_793H6eehHK93Llnw3gSYDklTIVpCCa_rgqoZtXFKKcKo99HtTDxqSvQpKP1vUFpwfQqqSN9eXA59GV6Ff5MpwMMMPKZsNnAFTMzOevjvZipP9WJxJe3WRA2B_wHsRLQO</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>Nakarai, Asuka</creator><creator>Kato, Jun</creator><creator>Hiraoka, Sakiko</creator><creator>Inokuchi, Toshihiro</creator><creator>Takei, Daisuke</creator><creator>Morito, Yuki</creator><creator>Akita, Mitsuhiro</creator><creator>Takahashi, Sakuma</creator><creator>Hori, Keisuke</creator><creator>Harada, Keita</creator><creator>Okada, Hiroyuki</creator><creator>Yamamoto, Kazuhide</creator><general>The Japanese Society of Internal Medicine</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140101</creationdate><title>Slight Increases in the Disease Activity Index and Platelet Count Imply the Presence of Active Intestinal Lesions in C-reactive Protein-negative Crohn's Disease Patients</title><author>Nakarai, Asuka ; Kato, Jun ; Hiraoka, Sakiko ; Inokuchi, Toshihiro ; Takei, Daisuke ; Morito, Yuki ; Akita, Mitsuhiro ; Takahashi, Sakuma ; Hori, Keisuke ; Harada, Keita ; Okada, Hiroyuki ; Yamamoto, Kazuhide</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c628t-2e7158d335af342502fcaac662bac714378e0b850895de667ab807c27bae02f83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Biomarkers - blood</topic><topic>C-reactive protein</topic><topic>C-Reactive Protein - metabolism</topic><topic>Colon - diagnostic imaging</topic><topic>Colon - pathology</topic><topic>Colonoscopy</topic><topic>Crohn Disease - blood</topic><topic>Crohn Disease - diagnosis</topic><topic>Crohn's disease</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Platelet Count</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Tomography, X-Ray Computed</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nakarai, Asuka</creatorcontrib><creatorcontrib>Kato, Jun</creatorcontrib><creatorcontrib>Hiraoka, Sakiko</creatorcontrib><creatorcontrib>Inokuchi, Toshihiro</creatorcontrib><creatorcontrib>Takei, Daisuke</creatorcontrib><creatorcontrib>Morito, Yuki</creatorcontrib><creatorcontrib>Akita, Mitsuhiro</creatorcontrib><creatorcontrib>Takahashi, Sakuma</creatorcontrib><creatorcontrib>Hori, Keisuke</creatorcontrib><creatorcontrib>Harada, Keita</creatorcontrib><creatorcontrib>Okada, Hiroyuki</creatorcontrib><creatorcontrib>Yamamoto, Kazuhide</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakarai, Asuka</au><au>Kato, Jun</au><au>Hiraoka, Sakiko</au><au>Inokuchi, Toshihiro</au><au>Takei, Daisuke</au><au>Morito, Yuki</au><au>Akita, Mitsuhiro</au><au>Takahashi, Sakuma</au><au>Hori, Keisuke</au><au>Harada, Keita</au><au>Okada, Hiroyuki</au><au>Yamamoto, Kazuhide</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Slight Increases in the Disease Activity Index and Platelet Count Imply the Presence of Active Intestinal Lesions in C-reactive Protein-negative Crohn's Disease Patients</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2014-01-01</date><risdate>2014</risdate><volume>53</volume><issue>17</issue><spage>1905</spage><epage>1911</epage><pages>1905-1911</pages><issn>0918-2918</issn><eissn>1349-7235</eissn><abstract>Objective Although the serum C-reactive protein (CRP) level may, to some extent, predict the disease activity in patients with Crohn's disease (CD), it is not always elevated during periods of disease activity. This study aimed to identify factors predicting the presence of active intestinal lesions in CD patients without an elevated CRP level. Methods CD patients in whom the presence or absence of active intestinal lesions was evaluated using endoscopic and/or radiologic modalities were divided into two groups based on a negative (<3 mg/L) or positive (≥3 mg/L) CRP level. The correlations between the presence of active intestinal lesions and various clinical variables, including the Crohn's Disease Activity Index (CDAI), leukocyte and platelet counts and hemoglobin, serum albumin and CRP levels, were determined in the CRP-negative patients. Results Of the 128 patients examined, 70 had a negative CRP status, approximately half of whom had active intestinal lesions. The multivariate analysis revealed a CDAI of >100 and platelet count of >33×104 /μL to be significant predictive factors for the presence of active lesions in the CRP-negative patients [CDAI >100, odds ratio (OR) =5.55; 95% confidence interval (CI), 1.80-18.74, platelet count >33×104 /μL, OR =5.94; 95% CI, 1.34-28.87]. The sensitivity of fulfillment of either criterion for the presence of active intestinal lesions was 83%, while the specificity of fulfillment of both criteria was 94%. Conclusion A relatively low CDAI and platelet count were identified as predictive markers of the presence of active intestinal lesions in CRP-negative CD patients. These results suggest that symptoms and laboratory data should be evaluated very carefully in such patients.</abstract><cop>Japan</cop><pub>The Japanese Society of Internal Medicine</pub><pmid>25175121</pmid><doi>10.2169/internalmedicine.53.2627</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Biomarkers - blood C-reactive protein C-Reactive Protein - metabolism Colon - diagnostic imaging Colon - pathology Colonoscopy Crohn Disease - blood Crohn Disease - diagnosis Crohn's disease Diagnosis, Differential Female Follow-Up Studies Humans Male Middle Aged Platelet Count Retrospective Studies Severity of Illness Index Tomography, X-Ray Computed Young Adult |
| title | Slight Increases in the Disease Activity Index and Platelet Count Imply the Presence of Active Intestinal Lesions in C-reactive Protein-negative Crohn's Disease Patients |
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