C-reactive protein measurement in children inflammatory bowel disease patients

C-reactive protein (CRP) is used to assess disease activity in diverse inflammatory disorders including inflammatory bowel disease (IBD). However, in IBD, a significant number of patients present with low CRP levels despite clinically active disease. In paediatric patients with IBD the performance of CRP is an understudied area. High-sensitivity CRP (hs-CRP) measures CRP levels that were previously thought to be under the detection limit. In paediatric IBD, this kind of highly sensitive marker is needed for the detection of the presence of inflammation.

A research team from Finland investigated the association between hs- CRP and clinical and histological activity in paediatric IBD patients, and evaluated the effect of glucocorticoid treatment on the hs-CRP levels. Their study will be published on June 21, 2010 in the World Journal of Gastroenterology.

The results showed that standard CRP test is negative in a considerable number of paediatric patients with active IBD and the routine measurement of CRP is thus not informative enough.

Hs-CRP detects low levels of CRP but disappointingly it does not help to distinguish children with active intestinal inflammation from those with quiescent disease or those responding to glucocorticoid treatment from non-responders. Interestingly, the levels of hs-CRP correlated with the presence of ileal inflammation.

This research reinforces the concept that a significant number of paediatric patients with active IBD may present with CRP levels that are under the detection limit. Hs-CRP instead, was detectable in all the patients. Unfortunately, in this pilot study the measurement of hs-CRP levels in the patients that had undetectable standard CRP levels could not stratify the patients according to disease activity or response to treatment.

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Reference - Sidoroff M, Karikoski R, Raivio T, Savilahti E, Kolho KL. High-sensitivity C-reactive protein in paediatric inflammatory bowel disease. World J Gastroenterol 2010; 16(23): 2901-2906

Correspondence to - Marianne Sidoroff, MD, Hospital for Children and Adolescents, University of Helsinki, Helsinki, FIN-00029, Finland. marianne.sidoroff@helsinki.fi

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2009 IF: 2.092. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.