Biological and histological parameters as predictors of relapse in ulcerative colitis: a prospective study

ABSTRACT

Ulcerative colitis is a chronic inflammatory disease of unknown etiology characterized by periods of remission and relapses. This study has been carried out in a group of North Indian patients where the disease has shown an increasing prevalence and frequent relapses. Hence, there is a need to predict relapse for better management and to reduce morbidity. To assess the importance of biological and histological parameters in predicting relapse when the disease is in quiescent phase. A prospective study of twenty-six patients with quiescent ulcerative colitis was carried out in Dayanand Medical College and Hospital, Punjab. Only patients with clinical and endoscopic remission at the time of screening visit were included. Hemoglobin, erythrocyte sedimentation rate [ESR], C- reactive protein [CRP] and serum Interleukin-6 [IL-6] levels were measured. The baseline colonoscopic mucosal biopsies were retrieved and studied. Follow-up was conducted for one year at monthly interval or earlier if relapse occurred. Fifteen out of twenty-six patients [57.69%] had evidence of clinical relapse during the follow-up. Hemoglobin, ESR, CRP and Il-6 levels were not found to be significant predictors of relapse. Increased number of eosinophils and neutrophils in the lamina propria were observed to be associated with significantly higher relapse rate. A higher risk of relapse in patients with quiescent colitis can be predicted by the presence of increased number of eosinphils and neutrophils in the lamina propria