Correlation between extraintestinal manifestations and clinical parameters with the histologic activity index in patients with inflammatory bowel diseases

Abstract

Bacground/Aim. Crohn's disease (CD) and ulcerative colitis (UC) are chronic, idiopathic, inflammatory diseases of the digestive tract. The aim of this study was to determine a possible correlation between the clinical parameters of the disease activity degree and the presence of extraintestinal manifestations with disease activity histopathological degree, in patients presented with CD and UC. Methods. This cross-sectional study included 134 patients (67 with CD and UC, respectively) treated at the Clinic of Gastroenterology, Clinical Center of Serbia, Belgrade. After clinical, laboratory, endoscopic, histopathologic and radiologic diagnostics, the patients were divided into two groups according to their histopathological activity. The group I comprised 79 patients whose values of five-grade histopathological activity were less than 5 (45 with CD and 34 with UC), while the group II consisted of 55 patients with the values higher than 5 (22 with CD and 33 with UC). The CD activity index (CDAI) and Truelove and Witts' scale of UC were used for clinical evaluation of the disease activity. Results. CD extraintestinal manifestations were present in 28.9% and 63.6% of the patients in the groups I and II, respectively (p < 0.05). Comparison of the mean CDAI values found a significant difference between these two patients groups (the group I: 190.0 ? 83.0, the group II: 263.4 ? 97.6; p < 0.05). No correlation of extraintestinal manifestations of the disease, Truelove and Witts' scale and histological activity was found in UC patients (p > 0.05). Conclusion. In the patients presented with CD, the extraintestinal manifestations with higher CDAI suggested a higher degree of histopathological activity. On the contrary, in the UC patients, Truelove and Witts' scale and extraintestinal manifestations were not valid predictors of the disease histopathological activity.Uvod/Cilj. Kronova bolest (Crohn's disease - CD) i ulcerozni kolitis (ulcerative colitis - UC) su hronicne, idiopatske, zapaljenske bolesti digestivnog trakta. Cilj rada bio je da se utvrdi da li kod bolesnika sa CD i UC postoji uzajamni odnos izmedju klinickih pokazatelja stepena aktivnosti bolesti i prisustva vancrevnih manifestacija sa patohistoloskim stepenom aktivnosti bolesti. Metode. Studija preseka obuhvatila je 134 bolesnika (67 sa CD i 67 sa UC) lecena u Klinici za gastroenterologiju Klinickog centra Srbije u Beogradu. Nakon klinicke, laboratorijske, endoskopske, patohistoloske i radioloske dijagnostike, bolesnici su na osnovu patohistoloske aktivnosti bolesti podeljeni u dve grupe. U grupu I svrstano je 79 bolesnika cije su vrednosti petostepenog gradusa patohistoloske aktivnosti bile manje od 5 (45 sa CD i 34 sa UC), dok je u grupi II bilo 55 bolesnika sa vrednostima vecim od 5 (22 sa CD i 33 sa UC). Za klinicku procenu aktivnosti bolesti koriscen je indeks aktivnosti CD bolesti (CDAI) i Truelove i Wittsova skala za UC. Rezultati. Vancrevne manifestacije CD bile su prisutne kod 28,9% bolesnika grupe I i 63,6% bolesnika grupe II (p < 0,05). Uporedjivanjem srednjih vrednosti CDAI uocena je statisticki znacajna razlika izmedju dve grupe bolesnika (grupa I: 190,0 ? 83,0, grupa II: 263,4 ? 97,6; p < 0,05). Kod bolesnika sa UC nije utvrdjena veza izmedju prisustva vancrevnih manifestacija bolesti, Truelove i Wittsove skale i patohistoloske aktivnosti bolesti (p > 0,05). Zakljucak. Kod bolesnika sa CD prisustvo vancrevnih manifestacija, zajedno sa visim CDAI, ukazuje na veci stepen patohistoloske aktivnosti bolesti. Nasuprot tome, kod bolesnika sa UC, Truelove i Wittsova skala i prisustvo vancrevnih manifestacija nisu bili pouzdani prediktori histoloskog stepena aktivnosti bolesti.