P166 Inflammatory bowel disease: risk factors to disease activity during pregnancy and postpartum

Abstract Background The literature suggests that inflammatory bowel disease (IBD) activity during the periconceptional period is a risk factor for active disease during pregnancy. This study aims to evaluate if there is influence of IBD characteristics (type, classification, duration, activity in the periconceptional period, severity and treatment of disease) on the frequency of active disease during pregnancy and postpartum. Methods Retrospective study that included pregnant women followed in Maternal-Fetal Medicine department at Hospital de Santa Maria diagnosed with IBD, with information on ≥2 of the referred variables and delivery between March 2012 and July 2018 (n = 37; 24 Crohn’s disease, CD and 13 ulcerative colitis, UC). The statistical tests used were chi-square and Fisher’s exact test. Results There was no statistically significant difference between CD and CU in the activity of IBD during pregnancy and postpartum. Diagnosis >5 years and >10 years ago was associated with lower frequency of active disease during pregnancy (15% vs. 78.6%, p < 0.005 and 8.3% vs. 59.1%, p = 0.009, respectively), but did not influence postpartum activity. Age at diagnosis (≤16 years or 17–40 years) did not appear to influence IBD activity. IBD activity during the periconceptional period and pregnancy had a statistically significant association (72.7% with active disease during the periconceptional period and pregnancy and 26.1% with quiescent IBD at the time of conception but active during pregnancy, p = 0.023). There were 3 cases of IBD remission during pregnancy (2 CD and 1 UC). Of the 15 cases of active disease during pregnancy, 6 of them (40%; 4 with CD and 2 with UC) were reactivations. 3 women had active IBD during the postpartum period and all of them already had active disease during pregnancy. Regarding severity, all cases of active IBD were classified as mild disease. The type of therapy (biological, corticosteroids, thiopurines, salicylates, antibiotics or lack of therapy) was not related to disease activity during pregnancy or postpartum. Prior bowel surgery related to IBD (n = 7, all with CD) was associated with a lower frequency of active disease during pregnancy (0% vs. 51.7%, p = 0.027). Conclusion The diagnosis of IBD for more than 5 or 10 years and previous bowel surgery were associated with a lower frequency of active disease during pregnancy. There was a relationship between IBD activity in the periconceptional period and pregnancy, which reinforces the importance of pregnancy planning and prior disease control.

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P430 Feasibility and reliability of gastrointestinal ultrasound in pregnant inflammatory bowel disease patients

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.559 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S391-S393

Author(s):

F de Voogd ◽

H Joshi ◽

E Van Wassenaer ◽

G D’Haens ◽

K Gecse

Keyword(s):

Inflammatory Bowel Disease ◽

Disease Activity ◽

Terminal Ileum ◽

Bowel Disease ◽

Activity Index ◽

Third Trimester ◽

Faecal Calprotectin ◽

Gastrointestinal Ultrasound ◽

Inflammatory Bowel ◽

Active Disease

Abstract Background Disease activity during pregnancy in women with inflammatory bowel disease (IBD) is associated with miscarriage, preterm delivery and low birth weight. Monitoring disease activity throughout the pregnancy is therefore important. Gastrointestinal ultrasound (GIUS) has a high potential as a point-of-care tool for monitoring disease activity in IBD as it has been shown to correlate well with endoscopy and magnetic resonance imaging. However, data are scarce on the use of GIUS in IBD throughout pregnancy. The aim of this prospective study is to determine the feasibility and reliability of GIUS in pregnant IBD patients. Methods Patients were included when visiting the outpatient IBD pregnancy clinic. At each trimester, clinical and biochemical disease activity was evaluated and GIUS was performed. Feasibility was assessed by the ability to visualise each bowel segment (terminal ileum (TI), ascending (AC), transverse (TC), descending (DC) and sigmoid colon (SC)). Reliability was evaluated by using clinical and biochemical disease activity as a gold standard. This was defined as a Harvey–Bradshaw Index ≥4 in Crohn’s disease (CD) or a Simple Clinical Colitis Activity Index ≥5 in ulcerative colitis and a faecal calprotectin (FCP)³ 250 mg/g. Bowel wall thickness (BWT) of > 3 mm in the colon and > 2mm in the terminal ileum was considered as signs of active inflammation on ultrasound. A Mann–Whitney U-test and chi-square were used for statistical analysis. Results Thirty-two IBD patients (54% CD) were studied. Both a GIUS and FCP was available in 18, 11 and 6 patients for the first, second and third trimester, respectively. Eleven of 32 (34%) patients had clinically active disease at least at one time point during the pregnancy. Table 1 shows the visibility per segment. When the active disease was defined as an FCP ≥ 250 mg/g, GIUS could distinguish active from the non-active disease in the first, second and third trimester with a sensitivity of 80%, 75% and 75% and specificity of 85%, 86% and 100%, respectively. FCP levels were significantly higher in patients with an active disease on GIUS regardless of the trimester (mean 1095.5 ± 1453.8 mg/g vs. 265.25 ± 649.8 mg/g, p < 0.0001). Conclusion GIUS is accurate to distinguish active from the quiescent disease in pregnancy. Feasibility to visualise the TI and the SC decreased during the second and third trimester, although active disease could still be detected. Consequently, GIUS is feasible and reliable to assess disease activity throughout pregnancy in IBD.

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Intestinal Ultrasound to Evaluate Treatment Response During Pregnancy in Patients With Inflammatory Bowel Disease

Inflammatory Bowel Diseases ◽

10.1093/ibd/izab216 ◽

2021 ◽

Author(s):

Floris De Voogd ◽

Harshad Joshi ◽

Elsa Van Wassenaer ◽

Steven Bots ◽

Geert D’Haens ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Disease Activity ◽

Treatment Response ◽

Bowel Disease ◽

Objective Evaluation ◽

Fecal Calprotectin ◽

Clinical Activity ◽

Third Trimester ◽

Inflammatory Bowel ◽

Active Disease

Abstract Introduction Active disease in inflammatory bowel disease patients during pregnancy is associated with poor maternal and fetal outcomes. Objective evaluation of disease activity is a core strategy in IBD, and during pregnancy noninvasive modalities are preferred. We aimed to evaluate feasibility and accuracy of intestinal ultrasound (IUS) to objectify disease activity throughout pregnancy. Methods Pregnant patients with known IBD were included and followed throughout pregnancy for clinical disease activity, with fecal calprotectin (FCP) and with IUS every trimester. Feasibility of IUS was assessed for all colonic segments and terminal ileum (TI). Intestinal ultrasound outcomes to detect active disease and treatment response were compared with clinical scores combined with FCP. Results In total, 38 patients (22 CD, 16 UC) were included, with 27 patients having serial IUS. Feasibility of IUS decreases significantly in third trimester for TI (first vs third trimester: 91.3% vs 21.7%, P < .0001) and sigmoid (first vs third trimester: 95.6% vs 69.5%, P = .023). Intestinal ultrasound activity showed moderate to strong correlation with clinical activity (r = 0.60, P < .0001) and FCP (r = 0.73, P < .0001). Throughout pregnancy, IUS distinguished active from quiescent disease with 84% sensitivity and 98% specificity according to FCP combined with clinical activity. IUS showed disease activity in >1 segment in 52% of patients and detected treatment response with 80% sensitivity and 92% specificity. Conclusions IUS is feasible and accurate throughout pregnancy, although visualization of the sigmoid and TI decreases in the third trimester. IUS provides objective information on disease activity, extent, and treatment response, even during second and third trimester, and offers a noninvasive strategy to closely monitor patients during pregnancy.

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P459 Expression of SerpinE1, a potential new disease activity marker, reflects therapeutic response in Inflammatory Bowel Disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.812 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S453-S453

Author(s):

B Jójrt ◽

T Molnár ◽

V Szabó ◽

Á Varga ◽

T Resál ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Disease Activity ◽

Bowel Disease ◽

Healthy Subjects ◽

Expression Patterns ◽

Invasive Disease ◽

Gene Expressions ◽

Inflammatory Bowel ◽

Active Disease ◽

Control Samples

Abstract Background Inflammatory Bowel Disease (IBD) occurs as a consequence of abnormal immune response generating unbalance between pro- and anti-inflammatory signalling. Analysis of cytokine profiles in view of different cytokine targeting or immunosuppressive therapy may open up new therapeutic targets and may reveal biological profiles that distinguish responders from non-responders before initiating therapy. The aim of present study was to determine cytokine profile of IBD patients and identify cytokines with predictive potential. Methods IBD patients with clinically active disease were enrolled in study. Blood and biopsy samples were obtained from 22 IBD patients and 5 healthy controls. Biopsies were taken from inflamed and non-inflamed part of colon of IBD patients. Total protein and mRNA were isolated from biopsy samples. Cytokine Array was used to analyse cytokine expression patterns. Serum and mucosal SerpinE1 levels were measured by ELISA and qRT-PCR. Results In samples from IBD patients, remarkable discrimination between inflamed, or non-inflamed areas was observed, whereas no pro-inflammatory cytokines were detected in control samples. SerpinE1 was presented in every inflamed biopsy samples, which was analyzed in more details. Mucosal expression of SerpinE1 differed significantly in healthy subjects compared to IBD patients with active disease (0 vs 24.06 pg/mg, p=0.02). After therapy induction a remarkable decrease was observed in the mucosal SerpinE1 concentration in responders (45.5 vs 9.7 pg/mg, p=0.02) versus non-responders (45 vs 61.2 pg/mg, p=0.3). Moreover, mean value of mucosal SerpinE1 did not differ significantly in healthy subjects compared to responders (5.7 vs. 0 pg/mg, p=0.12). In non-responders the fold changes of SerpinE1 gene expressions were significantly (p=0.001) higher than in responders. Lowest expression of SerpinE1 gene was measured in control samples, whereas the highest in untreated, inflamed biopsy samples. Serum and mucosal SerpinE1 concentrations were significantly higher in patients with active disease compared to inactive (tissue: 5 vs 47.4 pg/mg, p=0.00003; serum: 22.4 vs 25.94 mg/ml, p=0.022). Correlation analysis revealed that serum SerpinE1 correlates with disease activity (p<0,01, cut-off value: 22 mg/ml, sensitivity=80%, specificity=60%, accuracy=74%), whereas no correlation was observed between the mucosal SerpineE1 concentration and the disease activity (p>0.1, sensitivity=72%, specificity=77.8%, accuracy=73.5%). Conclusion These results suggest that serum and mucosal SeprinE1 expression reflects endoscopic activity of IBD. Correlation of SerpinE1expression between the blood and the bowel mucosa would open up new possibilities in non-invasive disease monitoring of IBD.

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P203 Sexual Dysfunction in Chronic Inflammatory Bowel Disease: Myth or Reality?

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.329 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S266-S266

Author(s):

A Hassine ◽

A Hammami ◽

W Ben Ameur ◽

W Dahmani ◽

N Elleuch ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Sexual Dysfunction ◽

Disease Activity ◽

Bowel Disease ◽

Severe Disease ◽

Chronic Inflammatory Bowel Disease ◽

Cross Sectional ◽

Significant Difference ◽

Inflammatory Bowel ◽

Chronic Inflammatory Bowel

Abstract Background Sexual dysfunction is often associated with impaired body image and quality of life in patients. However, little data exists on sexual dysfunction (SD) in patients with Chronic Inflammatory Bowel Disease (IBD). The aim of this study was to assess the prevalence and risk factors for sexual dysfunction in patients with IBD. Methods This is a cross-sectional study of all patients followed for IBD. Sexual function was assessed by the Female Sexual Index Function (FSIF) for women and the International Index of Erectile Function (IIEF) for men. Sexual dysfunction was confirmed when the total FSIF score was less than 26, or the IIEF score less than 26. Crohn’s disease (CD) activity was assessed by the Harvey-Bradshaw index (HBI), and that of ulcerative colitis (UC), by the clinical Mayo scores. Results We collected 100 patients, with a mean age of 42.18 ± 15.71 and a sex ratio (M / F) = 1.5. Sixty eight patients had CD and 32 patients had UC. Ano-perineal manifestations were present in 38.2% of cases. Severe disease activity was noted in 14 patients (20.6%) with CD and 10 patients (31.3%) with UC. Twelve patients had proctitis. 38% of patients had surgical treatment: 18.75% for patients with UC and 47.05% for those with CD. Total colectomy was performed in 12% of cases. At the time of the study, 20% of patients were on systemic corticosteroid therapy, 22% on Azathioprine, 4% on Salazopyrine, 8% on 5-ASA and 46% on Anti-TNFα. Sexual dysfunction was reported by 42.9% of women: 57.14% (UC) vs 38.46% (CD) (p = 0.042). On the other hand, sexual dysfunction was reported by 27.6% of men: 22.2% of men with UC and 28.57% with CD, with no statistically significant difference (p = 0.78). A significant association was found between sexual dysfunction and the degree of disease activity (p <0.001 for CD, p = 0.003 for UC), as well as pancolitic involvement in women with UC (p = 0.002). However, the presence of anoperineal manifestations, rectal involvement and history of surgery were not significantly associated with the frequency of sexual disturbances. Conclusion Our study showed a high prevalence of sexual dysfunction in patients with IBD. Training gastroenterologists in the management of sexual dysfunction would make it possible to satisfy patient expectations.

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Elevated ectodomain of type 23 collagen is a novel biomarker of the intestinal epithelium to monitor disease activity in ulcerative colitis and Crohn’s disease

United European Gastroenterology Journal ◽

10.1177/2050640620977371 ◽

2020 ◽

pp. 205064062097737

Author(s):

T Manon-Jensen ◽

S Sun ◽

M Lindholm ◽

V Domislović ◽

P Giuffrida ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Disease Activity ◽

Bowel Disease ◽

Surrogate Marker ◽

Area Under The Curve ◽

Inflammatory Bowel ◽

Active Disease

Background Impaired intestinal epithelial barrier is highly affected in inflammatory bowel disease. Transmembrane collagens connecting the epithelial cells to the extracellular matrix have an important role in epithelial cell homeostasis. Thus, we sought to determine whether the transmembrane type 23 collagen could serve as a surrogate marker for disease activity in patients with Crohn’s disease and ulcerative colitis. Methods We developed an enzyme-linked immunosorbent assay to detect the ectodomain of type 23 collagen (PRO-C23) in serum, followed by evaluation of its levels in both acute and chronic dextran sulfate sodium colitis models in rats and human inflammatory bowel disease cohorts. Serum from 44 Crohn’s disease and 29 ulcerative colitis patients with active and inactive disease was included. Results In the acute and chronic dextran sulfate sodium-induced rat colitis model, the PRO-C23 serum levels were significantly increased after colitis and returned to normal levels after disease remission. Serum levels of PRO-C23 were elevated in Crohn’s disease ( p < 0.05) and ulcerative colitis ( p < 0.001) patients with active disease compared to healthy donors. PRO-C23 differentiated healthy donors from ulcerative colitis (area under the curve: 0.81, p = 0.0009) and Crohn’s disease (area under the curve: 0.70, p = 0.0124). PRO-C23 differentiated ulcerative colitis patients with active disease from those in remission (Area under the curve: 0.75, p = 0.0219) and Crohn’s disease patients with active disease from those in remission (area under the curve: 0.68, p = 0.05). Conclusion PRO-C23 was elevated in rats with active colitis, and inflammatory bowel disease patients with active disease. Therefore, PRO-C23 may be used as a surrogate marker for monitoring disease activity in ulcerative colitis and Crohn’s disease.

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Assessment of quality of life of patients with inflammatory bowel disease residing in Southern Brazil

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032010000300014 ◽

2010 ◽

Vol 47 (3) ◽

pp. 285-289 ◽

Cited By ~ 11

Author(s):

Danielle Cohen ◽

Ceres Maltz Bin ◽

Ana Paula Trussardi Fayh

Keyword(s):

Quality Of Life ◽

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Disease Activity ◽

Bowel Disease ◽

Significant Difference ◽

Inflammatory Bowel

CONTEXT: Chronic diseases have an impact on the quality of life of the individuals. OBJECTIVE: To evaluate the quality of life of adults with inflammatory bowel disease by the inflammatory bowel disease questionnaire certified for Portuguese language. METHODS: We interviewed 50 individuals from both genders aged from 18 to 60 years old, with Crohn's disease and ulcerative colitis, regardless of disease activity. RESULTS: The average age of the sample was 42.2 ± 13.6 years old, the disease length was 98.8 ± 74.3 months, and 72% of patients had Crohn's disease and 14% presented disease activity. There was no significant difference in questionnaire scores of patients with different inflammatory bowel disease when they are in the remission phase (172.0 ± 42.4 and 173.6 ± 28.2 for ulcerative colitis and Crohn's disease, respectively, P = 0.886). When compared to scores of patients who were in crisis, it was found that they have a lower quality of life that patients in remission (123.8 ± 44.5 and 173.3 ± 31.5 for patients in crisis and remission, respectively, P = 0.001). CONCLUSION: It was noticed that the quality of life of patients with inflammatory bowel disease did not differ among patients with Crohn's disease or ulcerative colitis, when patients are in remission. The main aspect which determines the loss of quality of life would be being at the stage of disease activity.

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The Immunogenicity of the Influenza, Pneumococcal, and Hepatitis B Vaccines in Patients With Inflammatory Bowel Disease Treated With Vedolizumab

Crohn's & Colitis 360 ◽

10.1093/crocol/otaa082 ◽

2020 ◽

Vol 2 (4) ◽

Cited By ~ 1

Author(s):

Jill E Harrington ◽

Rachel E Hamilton ◽

Lisa Ganley-Leal ◽

Francis A Farraye ◽

Sharmeel K Wasan

Keyword(s):

Inflammatory Bowel Disease ◽

Hepatitis B ◽

Adverse Events ◽

Influenza Vaccine ◽

Disease Activity ◽

Bowel Disease ◽

Hepatitis B Vaccine ◽

Significant Difference ◽

Hepatitis B Vaccines ◽

Inflammatory Bowel

Abstract Background Patients with inflammatory bowel disease (IBD) have an elevated risk for infection which is further increased by immunosuppressive medications. The aim of this study was to evaluate the safety and immunogenicity of influenza, PVC13, PPSV23, and hepatitis B vaccines in adults with IBD treated with vedolizumab as compared to those treated with anti-tumor necrosis factor (TNF) agents or nonimmunosuppressive therapy. Methods In this prospective controlled trial, patients were vaccinated with the influenza, PVC13, PPSV23, and/or hepatitis B vaccines. Participants were grouped based on IBD medication regimen: (1) vedolizumab monotherapy, (2) vedolizumab plus immunomodulator, (3) anti-TNF plus immunomodulator, and (4) no immunosuppressive therapy (control). Vaccine responses were evaluated by comparing pre- and postvaccination titers. Disease activity and adverse events were monitored by the Harvey–Bradshaw Index or Simple Colitis Clinical Activity Index and by standardized phone interviews. Results No serious adverse events or significant changes in disease activity were reported. For the influenza vaccine, baseline titers were high in all groups, and no follow-up titers met criteria for adequate response. For the pneumococcal vaccines, all groups showed response to vaccination; there was no statistically significant difference between the groups. For the hepatitis B vaccine, 62.5% of patients receiving vedolizumab and 33.3% receiving anti-TNF therapy achieved a level of response >10 mIU/mL. Discussion The inability to observe a response to the influenza vaccine was influenced by high baseline titers. For the hepatitis B vaccine, patients treated with vedolizumab experienced immunogenic response to vaccination that was noninferior to nonimmunosuppressed controls. All studied vaccines were well-tolerated. Vaccination should be encouraged in all adult patients with IBD.

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P411 Faecal calprotectin is more tightly associated with endoscopic disease activity compared with other biomarkers in patients with inflammatory bowel disease under maintenance treatment with adalimumab

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.540 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S377-S377

Author(s):

E Orfanoudaki ◽

E Theodoraki ◽

K Foteinogianopoulou ◽

A Mantaka ◽

I Koutroubakis

Keyword(s):

Inflammatory Bowel Disease ◽

Disease Activity ◽

Maintenance Treatment ◽

The Other ◽

Inclusion Criteria ◽

Faecal Calprotectin ◽

Home Testing ◽

Significant Difference ◽

Inflammatory Bowel ◽

Active Disease

Abstract Background Fecal calprotectin (FC) has been suggested as an important biomarker for the management of patients with inflammatory bowel disease (IBD). It is an indirect index of disease activity and plays a crucial role in the treat-to-target strategy. Consecutive measurements of FC in patients in clinical remission can predict a disease relapse and lead to early treatment optimisation. We aimed to compare FC with other biomarkers as for their association with endoscopic activity in IBD patients under maintenance treatment with adalimumab. Methods Consecutive IBD patients under maintenance treatment with adalimumab were studied retrospectively based on prospectively recorded data in an IBD registry. Inclusion criteria were at least one available endoscopic evaluation with accompanied biomarkers measurement within the last ± 3 months in the study period (10/2016–9/2019). Biomarkers assessed were FC (home testing Βühlmann fCAL ELISA), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), haemoglobin (Hb), white blood cells (WBC) and platelets (PLT). The disease was considered as active if endoscopic Mayo score was ≥2 in ulcerative colitis (UC) and SES-CD score >6 for Crohn’s disease (CD). Results From a total of 72 IBD patients under maintenance treatment with adalimumab, 53 met inclusion criteria [49 CD, 32 men, mean age 42.3 ± 14.9 years, mean disease duration 13.4 ± 9.5, median adalimumab use 34 (23–65) months, combination with immunosuppressants 11 (22%)]. In the logistic regression analysis with dependent variable, the endoscopic active disease FC (mean value 470.8 ± 382.3μg/g) and ESR were independently significantly correlated with the endoscopic disease activity (OR:1.002 95% CI 1.001–1006, p = 0.003 and OR:1.05 95% CI 0.01–1010, p = 0.01 respectively). FC identified patients with endoscopic active disease with an area under the receiver operating characteristic curve (AUC) value of 0.78 (95% CI 0.64–0.88) higher than the other biomarkers [CRP, AUC 0.70 95% CI 0.56–0.82; Hb, AUC 0.55 95% CI 0.41–0.69; ESR, AUC 0.57 95% CI 0.43–0.71; PLT, AUC 0.56 95% CI 0.42–0.69 and WBC, AUC 0.43 95% CI 0.35–0.63). In the pairwise comparison of the ROC curves, there was a significant difference of the AUC of FC and the AUC of Hb, ESR, PLT and WBC (all with p < 0.05). There was no significant difference between the AUC of FC and that of CRP (p = 0.35). FC levels >413 μg/g had a sensitivity of 75% and a specificity of 76% in predicting endoscopic active disease. Conclusion These real-life results indicate that in IBD patients under maintenance treatment with adalimumab faecal calprotectin home testing performs better than the other biomarkers in predicting the disease endoscopic activity.

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IgG4 and IgG-positive plasma cell infiltration and high correlation with disease activity in patients with inflammatory bowel disease undergoing colectomy

10.21203/rs.3.rs-25117/v1 ◽

2020 ◽

Author(s):

Hong Yang ◽

Bo Chen ◽

Zheng Wang ◽

Xiyu Sun ◽

Bin Wu ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Disease Activity ◽

Plasma Cell ◽

Bowel Disease ◽

Cell Infiltration ◽

Control Group ◽

Characteristic Analysis ◽

Plasma Cell Infiltration ◽

Significant Difference ◽

Inflammatory Bowel

Abstract Background The aims of this study were to identify the distribution and the role of IgG-positive and IgG4-positive plasma cell infiltration in colonic mucosa in patients with inflammatory bowel disease (IBD). Methods Patients with IBD who were free from immunosuppressive agents were consecutively enrolled from 2010 to 2014. Sections from surgical specimens were stained with monoclonal antihuman IgG4 and IgG antibody using standard immunohistochemical techniques. Results In total, 49 patients (30 CD and 19 UC) were included in this study. There was abundant infiltration of IgG4-positive plasma cells in 4 patients with UC (IgG4-present, 21.1%) and 6 patients with CD (IgG4-present, 20.0%). A significantly higher number of IgG-positive cells and IgG4-positive cells were found in patients with CD and UC than in control group. Higher proportions of IgG4 correlated with higher endoscopic activity scoring, higher revised Mayo score, lower haemoglobin, higher erythrocyte sedimentation rate, higher high sensitive C-reactive protein (hsCRP) and higher D-dimer in patients with UC (P < 0.05). A significant difference was identified in terms of disease activity in the IgG-present group compared with the group with the IgG-absent group (69.2% vs 16.7% P < 0.05). If the cut-off value was set at 25 cells/HPF for IgG, the sensitivity and specificity of predicting severity potential in UC was 90.0% and 55.6%, respectively. The area under the curve was 0.633 by receiver operating characteristic analysis. Conclusions These findings suggest that IgG4 infiltration appears to be a relevant marker of inflammatory process caused by immune dysregulation in patients with IBD.

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