Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jun 21, 2010; 16(23): 2901-2906
Published online Jun 21, 2010. doi: 10.3748/wjg.v16.i23.2901
High-sensitivity C-reactive protein in paediatric inflammatory bowel disease
Marianne Sidoroff, Riitta Karikoski, Taneli Raivio, Erkki Savilahti, Kaija-Leena Kolho
Marianne Sidoroff, Taneli Raivio, Erkki Savilahti, Kaija-Leena Kolho, Division of Gastroenterology and Endocrinology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, FIN-00029, Finland
Riitta Karikoski, Department of Pathology, HUSLAB, Helsinki University Central Hospital, FIN-00029, Helsinki, Finland
Author contributions: Sidoroff M collected and analyzed the data and drafted the manuscript; Karikoski R performed the histological grading of the colonoscopy samples and revised the manuscript; Raivio T and Savilahti E participated in the writing of the manuscript; Kolho KL supervised the study, participated in the data analyses and in the writing of the manuscript.
Supported by Grants from the Finnish Cultural Foundation, the Emil Aaltonen Foundation, the Helsinki University Central Hospital Grant, the Finnish Paediatric Research Foundation, and the Päivikki and Sakari Sohlberg Foundation
Correspondence to: Marianne Sidoroff, MD, Hospital for Children and Adolescents, University of Helsinki, Helsinki, FIN-00029, Finland. marianne.sidoroff@helsinki.fi
Telephone: +358-9-47175726 Fax: +358-9-47175737
Received: February 4, 2010
Revised: March 26, 2010
Accepted: April 2, 2010
Published online: June 21, 2010
Abstract

AIM: To study whether high-sensitivity C-reactive protein (hs-CRP) measurement can aid the assessment of disease activity and glucocorticoid treatment in paediatric inflammatory bowel disease (IBD).

METHODS: CRP levels were measured in 39 children with IBD undergoing colonoscopy [median age 12.8 years, Crohn’s disease (CD) n = 20], in 22 other children with IBD followed for acute response to glucocorticoids, and in 33 paediatric non-IBD patients. When standard CRP level was below detection limit (< 5 mg/L), hs-CRP was analyzed.

RESULTS: Sixty-four percent (25/39) of the children with IBD undergoing colonoscopy displayed undetectable (< 5 mg/L) standard CRP levels. Of these, the hs-CRP measurement could not differentiate between active (median, 0.2 mg/L, range, 0.007-1.37, n = 17) or quiescent (0.1 mg/L, 0.01-1.89, n = 8, P = NS) disease. Patients with ileocolonic CD had higher CRP levels (14 mg/L, 0.06-45, n = 13) than patients with no ileal involvement (0.18 mg/L, 0.01-9, n = 7, P < 0.01) or ulcerative colitis (UC) (0.13 mg/L, 0.007-23, P < 0.05). In children with active IBD treated with systemic glucocorticoids, the standard CRP was undetectable in 59% of the patients. The hs-CRP levels did not differ between patients that responded to steroid therapy and in non-responders.

CONCLUSION: The measurement of hs-CRP did not prove useful in the assessment of disease activity or glucocorticoid treatment in paediatric IBD patients that had undetectable standard CRP.

Keywords: C-reactive protein; Crohn’s disease; Ulcerative colitis; Children; Inflammatory markers