scholarly journals The Use of Postoperative CRP Levels in Patients With Crohn’s Disease

2021 ◽  
Author(s):  
Moran Slavin ◽  
Avygial Goldstein ◽  
Barak Raguan ◽  
Yaron Rudnicki ◽  
Shmuel Avital ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Anastomotic Leak ◽  
Area Under The Curve ◽  
High Volume ◽  
Threshold Values ◽  
High Volume Center ◽  
Inflammatory Bowel ◽  
Colorectal Cancer Patients

Abstract Background: In colorectal cancer, CRP levels on postoperative days 3-4 have a strong negative predictive value for an anastomotic leak, with threshold values of ~15 on POD 3 and ~13 on POD 4. In Crohn’s disease, CRP levels are perceived as unreliable in the postoperative period because of the underlying inflammatory process. The aim of this study was to investigate the use of postoperative CRP levels in patients with Crohn’s Disease and set threshold values for this population. Methods: This is a retrospective study of the medical records of adult patients with Crohn’s Disease who underwent bowel anastomoses, at a single, high volume center. The operations were performed by a single colorectal consultant who is an inflammatory bowel disease specialist, between 1/2012 and 12/2017. Results: 92 operations were performed. Mean CRP levels and CRP threshold values were higher in the study’s population compared with studies on colorectal cancer patients. A CRP level of 19.56 mg\dL on postoperative day 3 had an area under the curve of 0.865 (sensitivity 88%, specificity 73%) and a NPV of 98% for an anastomotic leak. Patients with an anastomotic leak showed a trend towards decreased postoperative albumin levels (p=0.06). Conclusions: Postoperative CRP values are higher in Crohn’s Disease compared with colorectal cancer. Postoperative CRP levels may rule out anastomotic leaks in patients with Crohn’s Disease with threshold values of 20.3 mg/dL in POD 3, 19.5 mg/dL in POD 4 and 16.7 mg\dL in POD 5.

scholarly journals Postoperative CRP Levels Can Rule out Anastomotic Leaks in Crohn’s Disease Patients

2022 ◽  
Vol 12 (1) ◽  
pp. 54
Author(s):  
Moran Slavin ◽  
Avigayil Goldstein ◽  
Barak Raguan ◽  
Yaron Rudnicki ◽  
Shmuel Avital ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Anastomotic Leak ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
High Volume ◽  
Anastomotic Leaks ◽  
Threshold Values ◽  
Rule Out

Background: In colorectal cancer, C-reactive protein (CRP) levels on postoperative days 3–4 have a strong negative predictive value for an anastomotic leak, with threshold values of ~15 on post-operative day (POD) 3 and ~13 on POD 4. In Crohn’s disease, CRP levels are perceived as unreliable in the postoperative period because of the underlying inflammatory process. The aim of this study was to determine whether postoperative CRP levels can be used to rule out anastomotic leaks in patients with Crohn’s disease and to set CRP threshold values for this population. Methods: This was a retrospective study of a population of Crohn’s disease patients who underwent surgery with bowel anastomoses at a single high-volume center between 1/2012 and 12/2017. The operations were performed by a single colorectal consultant who is an inflammatory bowel disease specialist. Results: Ninety-two operations were performed. A CRP level of 19.56 mg/dL on postoperative day 3 had an area under the curve of 0.865 (sensitivity 88%, specificity 73%) and a negative predictive value (NPV) of 98% for an anastomotic leak. Patients with an anastomotic leak showed a trend towards decreased postoperative albumin levels (p = 0.06). Conclusions: Mean CRP levels and CRP threshold values were indeed higher in the study population compared with those in colorectal cancer patients. Threshold values were set at 20.3 mg/dL on POD 3, 19.5 mg/dL on POD 4 and 16.7 mg/dL on POD 5. These values had high NPVs and can be used to rule out anastomotic leaks in patients with Crohn’s disease after surgery with bowel anastomosis.

scholarly journals Cancer Risk in Inflammatory Bowel Disease

1995 ◽  
Vol 9 (1) ◽  
pp. 23-26 ◽  
Author(s):  
Anders M Ekbom
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Colonic Involvement ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
Risk Of Cancer

There is an increased risk of cancer in both ulcerative colitis and Crohn's disease. In 3121 patients with ulcerative colitis, 225 cases of cancer were diagnosed compared with 142.1 expected (standardized incidence ratio [SIR] 1.6, 95% CI 1.4 to 1.8), and in 1655 patients with Crohn's disease, 58 cases of cancer were detected compared with 47.1 expected (SIR 1.2, 95% CI 0.9 to 1.6). After excluding colorectal cancer the observed number of malignancies was very close to that expected for ulcerative colitis (SIR 1.0, 95% CI 0.9 to 1.2) and for Crohn's disease (SIR 1.1, 95% CI 0.8 to 1.5). Thus, the increased risk of cancer in inflammatory bowel disease is confined to colorectal cancer. In Crohn's disease 12 cases of colorectal cancer were observed (SIR 2.5, 95% CI 1.3 to 4.3). The increased risk was confined to those with colonic involvement and young age at diagnosis. In patients with colonic involvement and younger than age 30 years at diagnosis, the SIR was 20.9 (95% CI 6.8 to 48.7) versus 2.2 for those older than 30 years at diagnosis (95% CI 0.6 to 5.7). In ulcerative colitis 91 cases of colorectal cancer were observed with an SIR of 5.7 (95% CI 4.6 to 7.0). Extensive disease and young age at diagnosis were independent risk factors. Pancolitis at diagnosis resulted in an SIR of 14.8 (95% CI 11.4 to 18.9), 2.8 in left-sided colitis (95% CI 1.6 to 4.4) and 1.7 in proctitis (95% CI 0.8 to 3.2). There is great variation in the risk estimates in different studies worldwide. Different treatment strategies could be an explanation, a hypothesis that was substantiated in a study of 102 cases of colorectal cancer among patients with ulcerative colitis compared with 196 controls. Pharmacological therapy with sulfasalazine entailed a strong protective effect against colorectal cancer (relative risk of 0.34, 95% CI 0.190 to 0.62).

Predicting and explaining inflammation in Crohn’s disease patients using predictive analytics methods and electronic medical record data

2018 ◽  
Vol 25 (4) ◽  
pp. 1201-1218 ◽  
Author(s):  
Bhargava K Reddy ◽  
Dursun Delen ◽  
Rupesh K Agrawal
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Prediction Models ◽  
Predictive Analytics ◽  
Area Under The Curve ◽  
Gradient Boosting ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
The Impact ◽  
Disease Location

Crohn’s disease is among the chronic inflammatory bowel diseases that impact the gastrointestinal tract. Understanding and predicting the severity of inflammation in real-time settings is critical to disease management. Extant literature has primarily focused on studies that are conducted in clinical trial settings to investigate the impact of a drug treatment on the remission status of the disease. This research proposes an analytics methodology where three different types of prediction models are developed to predict and to explain the severity of inflammation in patients diagnosed with Crohn’s disease. The results show that machine-learning-based analytic methods such as gradient boosting machines can predict the inflammation severity with a very high accuracy (area under the curve = 92.82%), followed by regularized regression and logistic regression. According to the findings, a combination of baseline laboratory parameters, patient demographic characteristics, and disease location are among the strongest predictors of inflammation severity in Crohn’s disease patients.

Ileostomy reversal after subtotal colectomy in Crohn’s disease: a single institutional experience at a high-volume center

2020 ◽  
Vol 35 (12) ◽  
pp. 2361-2363
Author(s):  
Daniel Bitner ◽  
Anthony D’Andrea ◽  
Robert Grant ◽  
Prerna Khetan ◽  
Alexander J. Greenstein
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Subtotal Colectomy ◽  
High Volume ◽  
Ileostomy Reversal ◽  
Institutional Experience ◽  
High Volume Center

scholarly journals 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

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.

scholarly journals Colon Cancer in Patients with Crohn’s Disease and Diabetes Mellitus

2020 ◽  
Vol 26 (3) ◽  
pp. 150-153
Author(s):  
Popescu Razvan Catalin ◽  
Leopa Nicoleta ◽  
Micu Luminita Gentiana ◽  
Costea Daniel Ovidiu ◽  
Olteanu Cornelia Minodora ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Colorectal Cancer ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Unusual Case ◽  
Colon Adenocarcinoma ◽  
Low Grade ◽  
High Grade ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Abstract Introduction: Diabetes mellitus and colorectal cancer are diseases with an increasing impact on the population. Colorectal cancer is a well-recognized complication of inflammatory bowel diseases, such as ulcerative colitis and Crohn’s colitis. Here we describe an unusual case of diabetes mellitus, Crohn`s colitis-associated cancer. Case report: We report the case of a 49-year-old woman, known with Crohn's disease and diabetes, who developed a transverse colon adenocarcinoma associated with multiple outbreaks of high-grade or low-grade intraepithelial dysplasia/neoplasia, for which a subtotal proctocolectomy with ileorecto-anastomosis with “J” pouch it was made. Conclusions: The risk of colonic carcinoma in Crohn's disease is increasing. An association of colorectal cancer with diabet mellitus and inflammatory bowel disease has been established. From diagnosis to treatment the management of these cases can be difficult and challenging.

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