scholarly journals CLINICAL FORMS OF ULCERATIVE COLITIS AND THEIR FEATURES IN CHILDREN

2020 ◽  
Author(s):  
Денисова М. Ф. ◽  
Букулова Н. Ю.
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Process ◽  
Clinical Laboratory ◽  
Fecal Calprotectin ◽  
Clinical Activity ◽  
Clinical Forms ◽  
Γ Globulins ◽  
Endoscopic Characteristics ◽  
And Gender ◽  
The Relationship

This article presents frequency of occurrence of clinical forms of the disease depending on the localization and activity of the inflammatory process, their age and gender differences, risk factors and disease triggers, based on a retrospective analysis of 116 cases of children with ulcerative colitis at the age of 4-18 years. Comparative clinical, laboratory and endoscopic characteristics of total, segmental and distal colitis have been also analyzed. It was found that clinical activity of total colitis is characterized by more severe course of the disease, accompanied with systemic and local extraintestinal manifestations (OR = 4,504±0,506, p<0.05), more pronounced changes in hemo- and proteinogram parameters (p<0.05). Endoscopic criteria for differences in the clinical forms of ulcerative colitis are the presence of ulcers (OR = 9,667±0,645, p <0,05), erosions (OR = 3,569±0,429, p<0,05), contact bleeding (OR = 4,364± ,444, p< 0.05), changes in the vascular pattern (OR = 3,748±0,477, p<0.05). Correlation analysis of the relationship between clinical (PUCAI), endoscopic (Rachmilewitz index) and laboratory markers of the inflammatory process (leukocytes, platelets, erythrocyte sedimentation rate, γ-globulins, fecal calprotectin, hemoglobin) has been also performed, the criteria of which might be used to monitor the course of the disease and the effectiveness of therapy.

scholarly journals Fecal calprotectin is a useful biomarker for predicting the clinical outcome of granulocyte and monocyte adsorptive apheresis in ulcerative colitis patients: a prospective observation study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nobuhiro Ueno ◽  
Yuya Sugiyama ◽  
Yu Kobayashi ◽  
Yuki Murakami ◽  
Takuya Iwama ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Outcome ◽  
Sensitivity And Specificity ◽  
Reduction Rate ◽  
Fecal Calprotectin ◽  
Remission Induction ◽  
Clinical Activity ◽  
Observation Study ◽  
Mayo Score ◽  
Adsorptive Apheresis

Abstract Background Granulocyte and monocyte adsorptive apheresis (GMA) is widely used as a remission induction therapy for active ulcerative colitis (UC) patients. However, there are no available biomarkers for predicting the clinical outcome of GMA. We investigated the utility of Fecal calprotectin (FC) as a biomarker for predicting the clinical outcome during GMA therapy in active UC patients. Methods In this multicenter prospective observation study, all patients received 10 sessions of GMA, twice a week, for 5 consecutive weeks. FC was measured at entry, one week, two weeks, and at the end of GMA. Colonoscopy was performed at entry and after GMA. The clinical activity was assessed based on the partial Mayo score when FC was measured. Clinical remission (CR) was defined as a partial Mayo score of ≤ 2 and endoscopic remission (ER) was defined as Mayo endoscopic subscore of either 0 or 1. We analyzed the relationships between the clinical outcome (CR and ER) and the change in FC concentration. Result Twenty-six patients were included in this study. The overall CR and ER rates were 50.0% and 19.2%, respectively. After GMA, the median FC concentration in patients with ER was significantly lower than that in patients without ER (469 mg/kg vs. 3107 mg/kg, p = 0.03). When the cut-off value of FC concentration was set at 1150 mg/kg for assessing ER after GMA, the sensitivity and specificity were 0.8 and 0.81, respectively. The FC concentration had significantly decreased by one week. An ROC analysis demonstrated that the reduction rate of FC (ΔFC) at 1 week was the most accurate predictor of CR at the end of GMA (AUC = 0.852, P = 0.002). When the cut-off value of ΔFC was set at ≤ 40% at 1 week for predicting CR at the end of GMA, the sensitivity and specificity were 76.9% and 84.6%, respectively. Conclusion We evaluated the utility of FC as a biomarker for assessing ER after GMA and predicting CR in the early phase during GMA in patients with active UC. Our findings will benefit patients with active UC by allowing them to avoid unnecessary invasive procedures and will help establish new strategies for GMA.

scholarly journals Pathomorphological features of clinical forms of ulcerative colitis in children

2021 ◽  
Vol 16 (1) ◽  
pp. 1-7
Author(s):  
M.F. Denysova ◽  
T.D. Zadorozhna ◽  
N.Yu. Bukulova ◽  
T.М. Archakova
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Process ◽  
Unknown Origin ◽  
Chronic Inflammatory Disease ◽  
Clinical Forms ◽  
Biopsy Specimens ◽  
Histological Method ◽  
Intestine Mucosa ◽  
Mucous Barrier ◽  
Hematoxylin Eosin

Background. Ulcerative colitis is a chronic inflammatory disease of unknown origin, characterized by a clinically recurrent course with periods of bloody diarrhea and pathomorpholo­gical-diffuse inflammatory process in the colon. The problem of ulcerative colitis requires further study of the clinical features of the disease, taking into account the localization, degree of activity of the inflammatory process, changes in the structure of the mucous membrane that will help increase the efficiency of ulcerative colitis diagnosis in childhood. Materials and methods. On the basis of clinical and statistical analysis of 116 case histories of children aged 4–18 years with ulcerative colitis, the features of its clinical forms — total, segmental and distal — were studied during the period of exacerbation of the disease. Four hundred and forty-five biopsy specimens obtained during colonoscopy were histologically examined. After biopsy sampling, specimens were fixed in 10% formalin and were processed according to the generally accepted histological method with section staining using hematoxylin-eosin and according to Van Gieson. Results. Changes in the architecto­nics of the large intestine mucosa, which reduce the resistance of the mucous barrier, as well as impaired blood supply — a factor in the development of hemic hypoxia — are significant for the mechanisms of ulcerative colitis exacerbation.

scholarly journals Diagnostic Value of Clinical and Laboratory Parameters in the Diagnosis of Non-Specific Ulcer Colitis

2020 ◽  
Vol 5 (6) ◽  
pp. 136-140
Author(s):  
A. P. Lutsyk ◽  
◽  
E. I. Shorikov ◽  
Keyword(s):  
Computed Tomography ◽  
Ulcerative Colitis ◽  
Abdominal Pain ◽  
Clinical Laboratory ◽  
False Negative ◽  
Diagnostic Value ◽  
Fecal Calprotectin ◽  
Clinical Indicators ◽  
Laboratory Parameters ◽  
Highly Sensitive

The etiology of ulcerative colitis is still unknown. The number of works dealing with a comprehensive assessment of the role of clinical, laboratory, endoscopic, as well as immunological and genetic factors in the formation of unfavorable forms of ulcerative colitis is extremely small, and their results seem ambiguous. The purpose of the study was to determine the diagnostic value of clinical and laboratory signs in relation to verification of the depth of endoscopic lesion in patients with ulcerative colitis. Material and methods. 68 patients with ulcerative colitis (36 men and 32 women) were examined. The average age was 38.0±4.5 years. All patients were inspected with colonoscopy. Clinical, laboratory, immunological research, as well as computed tomography were carried out. Disease activity was determined according to the Truelove-Witts classification. Results and discussion. The obtained results showed that all intestinal symptoms (stool frequency more than 4 times a day, abdominal pain, tenesmus, hematochezia) had a reliable diagnostic value (р<0.05) in the presence of contact vulnerability and ulceration of the intestinal mucosa. The greatest sensitivity was characteristic of abdominal pain (94.1 [84.1-96.3]). It was found that the diagnostic sensitivity of tachycardia and uveitis is unreliable. Among the clinical indicators, the greatest diagnostic value was established for anemic syndrome (p<0.05), among additional signs was for sclerosing cholangitis (p<0.05). With regard to laboratory parameters, the diagnostic value was proven for hemoglobin levels <90 g/l (p<0.05) and hypoproteinemia (p<0.05). The diagnostic concentration of C-reactive protein for predicting a mucosal defect was determined at a level of more than 10 mg/L in terms of sensitivity and specificity (p<0.05). The level of fecal calprotectin more than 200 μg/g (p<0.05) was highly sensitive and highly specific. Conclusion. The study showed the possibilities of computed tomography for verifying of ulcerative defects. The method is highly sensitive in ulcerative colitis (sensitivity is 95.6 [85.9-97.1], specificity is (96.7 [83.3-99.4]), with a low probability of false-negative and false-positive results (p<0.05)

scholarly journals Lymphocyte-to-Monocyte Ratio as a Marker for Endoscopic Activity in Ulcerative Colitis

Immuno ◽  
2021 ◽  
Vol 1 (4) ◽  
pp. 360-368
Author(s):  
Natsuki Ishida ◽  
Satoru Takahashi ◽  
Yusuke Asai ◽  
Takahiro Miyazu ◽  
Satoshi Tamura ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Occult Blood ◽  
Fecal Calprotectin ◽  
Mucosal Healing ◽  
Reactive Protein ◽  
Lymphocyte To Monocyte Ratio ◽  
Endoscopic Score ◽  
The Relationship

Leukocyte subtypes can be used to evaluate the severity of ulcerative colitis (UC). In this study, we examined the relationship between the lymphocyte-to-monocyte ratio (LMR) and the Mayo endoscopic score (MES) in assessing endoscopic activity in UC. Eighty-nine samples of leukocyte subtypes and biomarkers, including fecal calprotectin (FC), the fecal immunochemical occult blood test (FIT), and C-reactive protein (CRP), from 71 patients with UC were retrospectively investigated, along with the MES. The MES was significantly correlated with the LMR, FC, the FIT, and CRP. There were significant differences in the LMR, FC, the FIT, and CRP between groups with an MES < 1 and >2 (p = 0.001, p = 0.003, p < 0.001, and p < 0.001, respectively). In the receiver operating characteristic (ROC) analysis for predicting mucosal healing (MES 0 or 1), the areas under the curve (AUCs) for the LMR, FC, the FIT, and CRP, were 0.712, 0.860, 0.908, and 0.796, respectively. In the analysis of patients without immunomodulators, the correlation of the MES with the LMR and CRP was significant. The LMR can be used to assess endoscopic activity in UC, particularly in patients without immunomodulators.

scholarly journals Colon epithelial barrier state in children with varios types of ulcerative colitis clinical forms

2021 ◽  
pp. 53-61
Author(s):  
M.F. Denisova ◽  
◽  
T.D. Zadorojna ◽  
N.Y. Bukulova ◽  
T.M. Archakova ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Mucous Membrane ◽  
Activity Index ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Fecal Calprotectin ◽  
Biochemical Properties ◽  
Epithelial Barrier ◽  
Inflammatory Infiltration ◽  
Clinical Forms

Purpose — analyse the state of the epithelial barrier of the colon in children with different clinical forms. Materials and methods. 42 children with acute chronic colitis were examined, including 28 with ulcerative colitis (14 with active total form, 14 with moderately active segmental); and 14 with chronic non-specific opaque colitis formed a comparison group. Laboratory methods were performed on all patients — hemogram, protein-gram, blood biochemistry, fecal calprotectin concentration; endoscopic examination with biopsy of all colon regions and histological examination of biopts. Results. The clinical manifestations of ulcerative colitis (UC) during the acute period were assessed by the Paediatric Activity Index (PUCAI) and depended on the localization and activity of the inflammatory process. The average for active colitis was found to be 50.2±1.8, moderate to 35.3±1.7, minimum to 24.1±1.2, but for children with total active inflammation 19 per cent of patients had the highest rates: 65, which corresponded to clinical signs of ulcerative colitis, accompanied by unidirectional changes of surface (dystrophic changes of epithelium, crypt deformation, reduced number of flax cells) and deep (diffuse inflammatory infiltration of its own plate, presence of crypt abscesses, cryptites, vascular dilation) structures of the mucous membrane of the large intestine, which are more pronounced in the active total forms of ulcerative colitis. The period of UC exacerbation is characterized by the violation of the epithelial barrier mucous membrane colon due to reduced mucus synthesis and changes in its biochemical properties, low secretory (MUC2) and membrane-associated (MUC4) expression Mucins, mainly in the active total forms of UC, loss of the regulatory effect of the club peptide on regeneration and protection of the mucous membrane of the intestine. Conclusions. Studies based on a pathogenetic approach to determining the cause of the exacerbation of the disease have shown evidence of a significant role in the epithelial barrier of the colon membrane, This is a significant addition to the known knowledge of ulcerative colitis pathogenesis in childhood. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. The authors declare no conflicts of interests. Key words: ulcerative colitis, children, epithelial barrier, mucins, clubs.

scholarly journals Fecal Calprotectin and Clinical Disease Activity in Pediatric Ulcerative Colitis

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Kaija-Leena Kolho ◽  
Dan Turner
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Outcome ◽  
Roc Curve ◽  
Clinical Remission ◽  
Activity Index ◽  
Fecal Calprotectin ◽  
Elisa Test ◽  
Clinical Activity ◽  
High Level ◽  
Active Disease

Objective. To explore fecal calprotectin levels in pediatric ulcerative colitis (UC) in relation with the validated clinical activity index PUCAI. Methods. This study included all 37 children (median age 14 years) with UC who had calprotectin measured (PhiCal ELISA Test) by the time of PUCAI assessment at the Children's Hospital of Helsinki in a total of 62 visits. Calprotectin values <100 μg/g of stool were considered as normal. The best cut-off value of each measure to predict 3-month clinical outcome was derived by maximizing sensitivity and specificity. Results. In clinically active disease (PUCAI ≥ 10), calprotectin was elevated in 29/32 patients (91% sensitivity). When in clinical remission, 26% (8/30) of the children had normal calprotectin but 7 (23%) had an exceedingly high level (>1000 μg/g). The best cut-off value for calprotectin for predicting poor outcome was 800 μg/g (sensitivity 73%, specificity 72%; area under the ROC curve being 0.71 (95%CI 0.57–0.85)) and for the PUCAI best cut-off values >10 (sensitivity 62%, specificity 64%; area under the ROC curve 0.714 (95%CI 0.58–0.85)). Conclusion. The clinical relevance of somewhat elevated calprotectin during clinical remission in pediatric UC is not known and, until further evidence accumulates, does not indicate therapy escalation.

Experience use of a non-invasive marker activity of inflammation in the colon in patients with colon polyps and ulcerative colitis

2015 ◽  
Vol 9 (1) ◽  
pp. 0-0
Author(s):  
Матюхин ◽  
A. Matyukhin ◽  
Никитин ◽  
A. Nikitin
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Process ◽  
Modern Method ◽  
Clinical Activity ◽  
Colon Polyps ◽  
Faecal Calprotectin ◽  
Non Invasive ◽  
Calprotectin Level ◽  
High Degree ◽  
Instrumental Methods

. The activity of a non-invasive marker of inflammation in the colon is used to evaluate the clinical, endoscopic and biological characteristics of ulcerative colitis and colon polyps. In this study, the authors studied the possibility of using non-invasive marker – a faecal calprotectin as a highly sensitive method in the activity of the inflammatory process in the colon. The study included 40 patients with ulcerative colitis and colon polyps, which a colonoscopy was performed. The concentration of calprotectin in stool samples was determined in all patients and was evaluated according to the clinical activity of the disease. A significant increase in the level of calprotectin in patients with colon polyps 42±5,6 µg/g wasn’t revealed. On the contrary, the concentration of a faecal calprotectin was significantly higher in patients with ulcerative colitis. This concentration increases in patients with a high degree of inflammatory activity and length of lesions of the mucous membrane of the colon. The concentration of calprotectin level correlates with the extent of lesion and activity of the inflam-matory process in the colon, but not with endoscopic activity of ulcerative colitis. The use of modern method of non-invasive diagnostic marker of the inflammatory process in the intestine allows to diagnose functional and organic pathologies of the colon without the supplementary instrumental methods.

scholarly journals The Relation Between Fecal Calprotectin and the Rate of Clinical Activity of Ulcerative Colitis

2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Hassan Vosoughinia ◽  
Maryam Latifnia ◽  
Mojtaba Fattahi Abdizadeh ◽  
Elham Mokhtari Amirmajdi ◽  
Mitra Ahadi
Keyword(s):  
Ulcerative Colitis ◽  
Fecal Calprotectin ◽  
Clinical Activity

scholarly journals Clinical Value of Fecal Calprotectin in Predicting Mucosal Healing in Patients With Ulcerative Colitis

2021 ◽  
Vol 8 ◽  
Author(s):  
Fang Chen ◽  
Yue Hu ◽  
Yi-Hong Fan ◽  
Bin Lv
Keyword(s):  
Ulcerative Colitis ◽  
Predictive Value ◽  
Fecal Calprotectin ◽  
Mucosal Healing ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Clinical Activity ◽  
Receiver Operator Characteristic ◽  
Characteristic Analysis ◽  
Active Disease

Aim: This study aimed to evaluate the clinical significance of fecal calprotectin (FC) in assessment of ulcerative colitis (UC) patients' endoscopic patterns and clinical manifestation.Methods: A total of 143 UC patients who received colonoscopy and 108 controls were included. After providing stool samples, patients underwent total colonoscopy. FC was measured by an enzyme-linked immunosorbent assay (ELISA). Clinical activity was based on the Mayo score. Endoscopic findings was scored by the Ulcerative Colitis Endoscopic Index of Severity (UCEIS). Correlation analysis and receiver-operator characteristic (ROC) analysis were carried out to determine the significance of measurements.Results: The median (interquartile range, IQR) of FC levels was 211 (43–990) μg/g in UC and 87.5 (40.50~181) μg/g in the control group. Fecal calprotectin correlated significantly with both Mayo and UCEIS scores (Spearman's r 0.670 and 0.592, P &lt; 0.01). With a cut-off value of 164 μg/g for fecal calprotectin concentration, the area under the curve (AUC) in receiver operator characteristic analysis was 0.830, sensitivity was 85.42%, specificity was 73.68%, positive predictive value (PPV) was 62.12%, and negative predictive value (NPV) was 9.10% in predicting clinical active disease. Similarly, the power of FC to predict mucosal healing (MH) was modest. With a cut-off value of 154.5 μg/g, the AUC was 0.839, sensitivity was 72.34%, and specificity was 85.71%.Conclusion: For evaluating the disease activity of UC, FC is a clinically relevant biomarker for both clinically active disease and MH in patients with UC. But the cut-off value still needs large and multicenter studies for confirmation.

scholarly journals Therapeutic Efficacy of pH-Dependent Release Formulation of Mesalazine on Active Ulcerative Colitis Resistant to Time-Dependent Release Formulation: Analysis of Fecal Calprotectin Concentration

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Kousaku Kawashima ◽  
Shunji Ishihara ◽  
Takafumi Yuki ◽  
Koji Onishi ◽  
Yoshinori Kushiyama ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Efficacy ◽  
Activity Index ◽  
Fecal Calprotectin ◽  
Mucosal Healing ◽  
Time Dependent ◽  
Clinical Activity ◽  
Active Ulcerative Colitis ◽  
Release Formulation ◽  
Ph Dependent

Purpose. Few reports have compared the clinical efficacy of a pH-dependent release formulation of mesalazine (pH-5-ASA) with a time-dependent release formulation (time-5-ASA). We examined whether pH-5-ASA is effective for active ulcerative colitis (UC) in patients resistant to time-5-ASA.Methods. We retrospectively and prospectively analyzed the efficacy of pH-5-ASA in mildly to moderately active UC patients in whom time-5-ASA did not successfully induce or maintain remission. The clinical efficacy of pH-5-ASA was assessed by clinical activity index (CAI) before and after switching from time-5-ASA. In addition, the efficacy of pH-5-ASA on mucosal healing (MH) was evaluated in a prospective manner by measuring fecal calprotectin concentration.Results. Thirty patients were analyzed in a retrospective manner. CAI was significantly reduced at both 4 and 8 weeks after switching to pH-5-ASA. In the prospective study (n=14), administration of pH-5-ASA also significantly reduced CAI scores at 4 and 8 weeks in these patients who were resistant to time-5-ASA. In addition, fecal calprotectin concentration was significantly decreased along with improvement in CAI after switching to pH-5-ASA.Conclusions. Our results suggest that pH-5-ASA has clinical efficacy for mildly to moderately active patients with UC in whom time-5-ASA did not successfully induce or maintain remission.

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