The value of inflammation and coagulation markers for the assessment of the activity and clinical outcome of ulcerative colitis

Abstract

Aim: To investigate the value of various laboratory parameters
in assessing the activity (diagnostic accuracy) and predicting
the response to treatment (predictive value) of ulcerative colitis
(UC). Methodology: Thirty-two patients with active and
12 patients with long standing inactive UC, based on clinical,
endoscopic and histologic scores, were included. Laboratory
routine variables (haemoglobin, platelets, albumin), inflammation
(erythrocyte sedimentation rate [ESR], C-reactive protein
[CRP], fibrinogen) and coagulation (D-Dimers, prothrombin
fragments 1+2, thrombin-antithrombin complex, von Willebrand
and VIII factors) indices were measured at baseline and
after 12 weeks of treatment. The diagnostic accuracy (sensitivity,
specificity, likelihood ratio) and the predictive value of
all laboratory variables were calculated. Results: ESR, CRP,
fibrinogen, haemoglobin, and von Willebrand factor, showed
significant diagnostic accuracy, only when patients with long
standing inactive UC, and not those in recent after treatment
remission, were included in the calculations. Fibrinogen was
the only variable that constantly differed significantly between
patients with active and inactive disease (recent or long standing).
None of the variables measured at baseline evaluation
was effective in predicting the response to treatment. Conclusion:Inflammation variables, especially fibrinogen, are valuable
markers of UC activity, while markers of coagulation
and fibrinolysis activation are not. Laboratory variables are
poor predictors of treatment response in active colitis. Endoscopy
seems to be the most accurate and valuable tool for the
assessment of colitis activity and monitoring the effect of treatment
in UC patients.
Key words: Coagulation, D-Dimers, factor VIII, fibrinolysis,
inflammation, inflammatory bowel disease (IBD), prothrombin
fragment 1 and 2 (F1+2), thrombin-antithrombin complex (TAT),
ulcerative colitis (UC), von Willebrand factor.