Additional benefit of procalcitonin to C-reactive protein for assessing disease activity and severity in Crohn's disease

Abderrahim Oussalah (1, 2) , Valérie M. Laurent (3) , Olivier Bruot (3) , Jean-Louis Gueant (2, 1) , Denis Régent (3) , Marc-André Bigard (2, 1) , Laurent Peyrin-Biroulet (2, 1)

1 Service d'Hépato-gastro-entérologie [CHRU Nancy]
2 NGERE - Nutrition-Génétique et Exposition aux Risques Environnementaux
3 Service de Radiologie [CHRU Nancy]

Background: Serum procalcitonin level (SPL) may reflect non-infectious inflammation. Aim: To assess the correlation of SPL with clinical, biological, endoscopic and radiological markers of disease activity in inflammatory bowel diseases (IBD) and to evaluate the additional diagnostic benefit of measuring SPL to that of C-reactive protein (CRP) for disease activity appraisal. Methods: We performed a prospective observational study. Spearman's rank correlation and receiver operating characteristic analysis were used to evaluate correlation and diagnostic accuracy, respectively. Results: In Crohn's disease (CD) (n=30), SPL was strongly correlated with clinical, biological, endoscopic and radiological disease activity markers. In CD, a SPL >0.14 µg/L demonstrated a high accuracy for detecting severe disease (Sensitivity=100%; Specificity=96%; AUROC=0.963; P=0.0001). The diagnostic accuracy of the 'SPL-CRP strategy' (CRP >5 mg/L and SPL >0.05 µg/L) was significantly superior to that of CRP alone for diagnosing severe CD (AUROC=0.783 versus 0.674; P=0.01). In ulcerative colitis (UC) (n=27), SPL was correlated with CRP and with endoscopic and radiological disease activity markers. Conclusions: In CD, the SPL was correlated with all disease activity markers and a cut-off of 0.14 µg/L could distinguish severe forms of the disease. The 'SPL-CRP strategy' was superior to CRP alone for diagnosing active or severe CD.

Mots clés: serum procalcitonin level; Crohn's disease; ulcerative colitis; inflammatory bowel diseases.; inflammatory bowel diseases

Abderrahim Oussalah, Valérie M. Laurent, Olivier Bruot, Jean-Louis Gueant, Denis Régent, et al.. Additional benefit of procalcitonin to C-reactive protein for assessing disease activity and severity in Crohn's disease: Procalcitonin in inflammatory bowel diseases. Alimentary Pharmacology and Therapeutics, 2010, 32 (9), pp.1135. ⟨10.1111/j.1365-2036.2010.04459.x⟩. ⟨hal-00577004⟩