Clinical and Laboratory Observation
Use of C-Reactive Protein in Children with Newly Diagnosed Inflammatory Bowel Disease

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C-reactive protein (CRP), a marker for inflammation, was evaluated with other routine blood tests in children with newly diagnosed inflammatory bowel disease. Evaluation of CRP level helped identify additional patients found to have inflammatory bowel disease at endoscopy, although a sizeable number of patients with mild ulcerative colitis had a normal CRP level.

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Methods

This study was conducted between January 2005 and December 2008. Research Ethics Board approval was obtained at both centers. Charts of patients with newly diagnosed IBD were reviewed. Diagnosis was based on the usual clinical, radiologic, endoscopic, and histological criteria.3 The few patients with indeterminate colitis were not included. Disease location was classified using the Montreal classification system.8 Disease activity was determined using the Pediatric Crohn’s Disease Activity

Results

A total of 258 patients (40% with UC and 60% with CD) with newly diagnosed IBD were included into the study (Table I). Comparisons of subjects with elevated CRP values showed that subjects with CD with isolated colonic disease were more likely to have a lower CRP compared with those with isolated ileal disease [mean log(CRP) of isolated ileal disease vs mean log(CRP) of isolated colonic disease, P = .02] or ileocolonic disease [mean log(CRP) of ileocolonic disease vs mean log(CRP) of isolated

Discussion

The addition of CRP to a complete blood count, albumin level, and ESR identifies most patients with IBD. The one exception is patients with mild UC, many of whom have normal blood test results. Many patients with moderate/severe UC still maintain normal complete blood count, albumin, ESR and CRP values. The differences among the subtypes of IBD may be related to the lack of transmural inflammation in UC.11 Although some newer stool tests are available, even these tests do not differentiate

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The authors declare no conflicts of interest.

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