Clinical utility of C-reactive protein in patients with ileal pouch anal anastomosis†

Lü, Hong; Lian, Lei; Navaneethan, Udayakumar; Shen, Bo

doi:10.1002/ibd.21239

Cited by 17 publications

(9 citation statements)

References 42 publications

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“…In a study of 104 patients from Finland, a significant correlation was found between the ESR and the PDAI score [44]. Similarly, in a large follow-up study of biochemical parameters 10-20 years after pouch construction, elevated ESR was seen in 13% of patients, which was correlated significantly with episodes of pouchitis [45].…”

Section: Laboratory Testsmentioning

confidence: 92%

Diagnosis and Management of Pouchitis and Ileoanal Pouch Dysfunction

Navaneethan

Shen

2010

Curr Gastroenterol Rep

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Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become the surgical treatment of choice for patients with medically refractory ulcerative colitis (UC) or UC with dysplasia and for the majority of patients with familial adenomatous polyposis. However, UC patients with IPAA are susceptible to inflammatory and noninflammatory sequelae, such as pouchitis, Crohn's disease of the pouch, cuffitis, and irritable pouch syndrome, in addition to common surgery-associated complications, which adversely affect the surgical outcome and compromise health-related quality of life. Pouchitis is the most frequent long-term complication of IPAA in patients with UC, with a cumulative prevalence of up to 50%. Pouchitis may be classified based on the etiology into idiopathic and secondary types, and the management is often different. Pouchoscopy is the most important tool for the diagnosis and differential diagnosis in patients with pouch dysfunction. Antibiotic therapy is the mainstay of treatment for active pouchitis. Some patients may develop dependency on antibiotics, requiring long-term maintenance therapy. Although management of antibiotic-dependent or antibiotic-refractory pouchitis has been challenging, secondary etiology for pouchitis should be evaluated and modified, if possible.

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Section: Laboratory Testsmentioning

confidence: 92%

Diagnosis and Management of Pouchitis and Ileoanal Pouch Dysfunction

Navaneethan

Shen

2010

Curr Gastroenterol Rep

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“…58 Likewise, in a Cleveland Clinic study, there was only limited clinical utility to a "snapshot" measurement of CRP in distinguishing normal from inflamed ileal pouches after total proctocolectomy for UC. 61 The prospects would therefore seem dim for any of these serum biomarkers to gain general acceptance as reliable substitutes or surrogate markers for endoscopy or histology.…”

Section: Endoscopymentioning

confidence: 99%

Role of Biomarkers in the Study and Management of Inflammatory Bowel Disease

Sachar

2014

Inflammatory Bowel Diseases

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“…Three studies evaluated the construct validity of the PDAI using the PAS, 38,40,44 and 5 studies used clinical symptoms, the PDAI clinical, endoscopic, and/or histologic subscores for comparisons. 37,39,45,46,48 The correlation between the PDAI and PAS (k = 0.55) was assessed in one study. 40 Correlations between the PDAI and the PDAI clinical subscore (Spearman correlation coefficient = 0.59, P < 0.001) and the PDAI endoscopic subscore (Spearman correlation coefficient = 0.78, P < 0.001) were assessed in 1 study 40 and between the PDAI and the PDAI histologic subscore in 2 studies (Spearman correlation coefficient = 0.57 and r = 0.82, respectively; P < 0.001 for both correlations).…”

Section: Pouchitis Disease Activity Indexmentioning

confidence: 99%

“…Among the identified studies, 73.7% (14 of 19) used stool or serum biomarkers as benchmarks for criterion validity. 15,39,[41][42][43][46][47][48][49][51][52][53][54][55] The PDAI was evaluated through correlation with fecal calprotectin (FCP; r = 0.188 to 0.71), fecal lactoferrin (r = 0.570 to 0.582), and C-reactive protein (CRP; r = 0.584). Two studies assessed correlation of the mPDAI with FCP (r = 0.476 and r = 0.565, respectively).…”

Section: Histologic Itemsmentioning

confidence: 99%

Disease Activity Indices for Pouchitis: A Systematic Review

Sedaño

Nguyen²,

Almradi

et al. 2021

Inflammatory Bowel Diseases

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Background Several indices exist to measure pouchitis disease activity; however, none are fully validated. As an initial step toward creating a validated instrument, we identified pouchitis disease activity indices, examined their operating properties, and assessed their value as outcome measures in clinical trials. Methods Electronic databases were searched to identify randomized controlled trials including indices that evaluated clinical, endoscopic, or histologic pouchitis disease activity. A second search identified studies that assessed the operating properties of pouchitis indices. Results Eighteen randomized controlled trials utilizing 4 composite pouchitis disease activity indices were identified. The Pouchitis Disease Activity Index (PDAI) was most commonly used (12 of 18; 66.7%) to define both trial eligibility (8 of 12; 66.7%), and outcome measures (12 of 12; 100%). In a separate search, 21 studies evaluated the operating properties of 3 pouchitis indices; 90.5% (19 of 21) evaluated validity, of which 42.1% (8 of 19) evaluated the construct validity of the PDAI. Criterion validity (73.7%; 14 of 19) was evaluated through correlation of the PDAI with fecal calprotectin (FCP; r = 0.188 to 0.71), fecal lactoferrin (r = 0.570 to 0.582), and C-reactive protein (CRP; r = 0.584). Two studies assessed correlation of the modified PDAI (mPDAI) with FCP (r = 0.476 and r = 0.565, respectively). Fair to moderate inter-rater reliability of the PDAI (k = 0.440) and mPDAI (k = 0.389) was reported in a single study. Responsiveness of the PDAI pre-antibiotic and postantibiotic treatment was partially evaluated in a single study of 12 patients. Conclusions Development and validation of a specific pouchitis disease activity index is needed given that existing instruments are not valid, reliable, or responsive.

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Clinical utility of C-reactive protein in patients with ileal pouch anal anastomosis†

Cited by 17 publications

References 42 publications

Diagnosis and Management of Pouchitis and Ileoanal Pouch Dysfunction

Diagnosis and Management of Pouchitis and Ileoanal Pouch Dysfunction

Role of Biomarkers in the Study and Management of Inflammatory Bowel Disease

Disease Activity Indices for Pouchitis: A Systematic Review

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