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Kırmızı kan hücresi dağılım genişliği (RDW) ülseratif kolit hastalarında klinik ve endoskopik aktiviteyi tahmin edebilir mi?

Year 2020, , 271 - 275, 01.04.2020
https://doi.org/10.28982/josam.712289

Abstract

Amaç: Ülseratif kolitin (ÜK) hastalık aktivitesi ve şiddetine göre sınıflandırılması klinik uygulamada önemlidir, çünkü hastanın yönetimini belirler. Bu çalışmada, ÜK hastalarında kırmızı kan hücresi dağılım genişliği (RDW) ile klinik aktivite indeksi (KAİ) ve mukozal hastalığa göre hastalık şiddetini belirleyen endoskopik aktivite indeksleri (EAİ) arasındaki ilişkiyi araştırmayı amaçladık.
Yöntemler: Araştırma bir vaka kontrol çalışması olarak planlandı. ÜK tanısı alan 99 hasta klinik ve endoskopik aktivitelerine göre aktif hastalık grubu ve remisyon grubu olmak üzere iki gruba ayrıldı. Kolonoskopi yapılan ve normal bulunan 56 kişiden yaş ve cinsiyet uyumlu kontrol grupları oluşturuldu.
Bulgular: Serum RDW düzeyleri ÜK grubunda anlamlı olarak yüksekti (P<0,001). RDW ile yapılan post-hoc karşılaştırmalarda, kontrol grubu ile aktif hastalık grupları arasında istatistiksel olarak anlamlı farklılıklar gözlenmiştir (P<0,001). Bununla birlikte, RDW değerleri klinik ve endoskopik aktivitenin belirlenmesinde, aktif hastalık ve remisyon grupları arasında anlamlı değildi (sırasıyla P=0,05 ve P=0,09). Klinik ve endoskopik aktivite indekslerini tahmin ederken, RDW'nin cut-off değerleri sırasıyla 14,25 (%66 duyarlılık ve %72 özgüllük) ve 13,75 (%64 duyarlılık ve %62 özgüllük) idi.
Sonuç: Bu çalışma, RDW'nin ülseratif kolitte hastalık aktivitesi için bir belirteç olarak kullanılabileceğini gösterdi, ancak remisyon ve aktif hastalık ayrımında aynı etkinliği göstermedi.

References

  • 1. Lamb CA, Kennedy NA, Raine T, Hendy PA, Smith PJ, Limdi JK, et al. British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut. 2019 Dec;68(Suppl 3): s1-s106. doi:0.1136/gutjnl-2019-3184841
  • 2. Caprilli R, Viscido A, Latella G. Current management of severe ulcerative colitis. Nat Clin Pract Gastroenterol Hepatol. 2007 Feb;4(2):92-101. doi: 10.1038/ncpgasthep0687.
  • 3. Lok KH, Ng CH, Hung HG, Li KF, Li KK, Szeto ML. Correlation of serum biomarkers with clinical severity and mucosal inflammation in Chinese ulcerative colitis patients. J Dig Dis. 2008 Nov;9(4):219-24. doi: 10.1111/j.1751-2980.2008.00350.x.
  • 4. Hassan EA, Ramadan HK, Ismael AA, Mohamed KF, El-Attar MM, Alhelali I. Noninvasive biomarkers as surrogate predictors of clinical and endoscopic remission after infliximab induction in patients with refractory ulcerative colitis. Saudi J Gastroenterol. 2017 Jul-Aug;23(4):238-245. doi: 10.4103/sjg.SJG_599_16.
  • 5. Vermeire S, Van Assche G, Rutgeerts P. Laboratory markers in IBD: useful, magic, or unnecessary toys? Gut. 2006 Mar;55(3):426-31. doi: 10.1136/gut.2005.069476.
  • 6. Karnad A, Poskitt TR. The automated complete blood cell count. Use of the red blood cell volume distribution width and mean platelet volume in evaluating anemia and thrombocytopenia. Arch Intern Med. 1985 Jul;145(7):1270-2. doi: 10.1001/archinte.145.7.1270.
  • 7. Goyal H, Lippi G, Gjymishka A, John B, Chhabra R, May E. Prognostic significance of red blood cell distribution width in gastrointestinal disorders. World J Gastroenterol. 2017 Jul 21;23(27):4879-4891. Doi: 10.3748/wjg.v23.i27.4879.
  • 8. Hammarsten O, Jacobsson S, Fu M. Red cell distribution width in chronic heart failure: a new independent marker for prognosis? Eur J Heart Fail. 2010 Mar;12(3):213-4. doi: 10.1093/eurjhf/hfp208.
  • 9. Chen GP, Huang Y, Yang X, Feng JF. A Nomogram to Predict Prognostic Value of Red Cell Distribution Width in Patients with Esophageal Cancer. Mediators Inflamm. 2015:2015:854670. doi: 10.1155/2015/854670.
  • 10. Celikhisar H, Dasdemir Ilkhan. Comparison of erythrocyte distribution width, mean platelet volume and platelet distribution width in patients with obstructive sleep apnea syndrome. J Surg Med. 2019;3(10):734-9. doi: 10.28982/josam.622377
  • 11. Cakal B, Akoz AG, Ustundag Y, Yalinkilic M, Ulker A, Ankarali H. Red cell distribution width for assessment of activity of inflammatory bowel disease. Dig Dis Sci. 2009 Apr;54(4):842-7. doi: 10.1007/s10620-008-0436-2.
  • 12. Song CS, Park DI, Yoon MY, Seok HS, Park JH, Kim HJ et al. Association between red cell distribution width and disease activity in patients with inflammatory bowel disease. Dig Dis Sci. 2012 Apr;57(4):1033-8. Doi: 10.1007/s10620-011-1978-2. Epub 2011 Dec 7.
  • 13. Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut. 2006 Jun;55(6):749-53. doi: 10.1136/gut.2005.082909.
  • 14. Feagan BG, Greenberg GR, Wild G, Fedorak RN, Paré P, McDonald JW et al. Treatment of ulcerative colitis with a humanized antibody to the alpha4beta7 integrin. N Engl J Med. 2005 Jun 16;352(24):2499-507. doi: 10.1056/NEJMoa042982.
  • 15. Lee JS, Kim ES, Moon W. Chronological Review of Endoscopic Indices in Inflammatory Bowel Disease. Clin Endosc. 2019 Mar;52(2):129-36. doi: 10.5946/ce.2018.042.
  • 16. Rosenberg L, Lawlor GO, Zenlea T, Goldsmith JD, Gifford A, Falchuk KR, et al. Predictors of endoscopic inflammation in patients with ulcerative colitis in clinical remission. Inflamm Bowel Dis. 2013 Mar-Apr;19(4):779-84. doi: 10.1097/MIB.0b013e3182802b0e.
  • 17. D'Haens G, Sandborn WJ, Feagan BG, Geboes K, Hanauer SB, Irvine EJ, et al. A review of activity indices and efficacy end points for clinical trials of medical therapy in adults with ulcerative colitis. Gastroenterology. 2007 Feb;132(2):763-86. doi: 10.1053/j.gastro.2006.12.038.
  • 18. Osada T, Ohkusa T, Okayasu I, Yoshida T, Hirai S, Beppu K, et al. Correlations among total colonoscopic findings, clinical symptoms, and laboratory markers in ulcerative colitis. J Gastroenterol Hepatol. 2008 Dec;23 Suppl 2:S262-7. doi: 10.1111/j.1440-1746.2008.05413.x.
  • 19. Yoon JY, Park SJ, Hong SP, Kim TI, Kim WH, Cheon JH. Correlations of C-reactive protein levels and erythrocyte sedimentation rates with endoscopic activity indices in patients with ulcerative colitis. Dig Dis Sci. 2014 Apr;59(4):829-37. doi: 10.1007/s10620-013-2907-3. Epub 2013 Dec 19.
  • 20. Karoui S, Laz S, Serghini M, Bibani N, Boubaker J, Filali A. Correlation of C-reactive protein with clinical and endoscopic activity in patients with ulcerative colitis. Dig Dis Sci. 2011 Jun;56(6):1801-5. doi: 10.1007/s10620-010-1496-7.
  • 21. Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJ, Pfeffer MA et al. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol. 2007 Jul 3;50(1):40-7. doi: 10.1016/j.jacc.2007.02.067.
  • 22. Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med. 2005 Mar 10;352(10):1011-23. doi: 10.1056/NEJMra041809.
  • 23. Yeşil A, Senateş E, Bayoğlu IV, Erdem ED, Demirtunç R, Kurdaş Övünç AO. Red cell distribution width: a novel marker of activity in inflammatory bowel disease. Gut Liver. 2011 Dec;5(4):460-7. doi: 10.5009/gnl.2011.5.4.460.
  • 24. Oustamanolakis P, Koutroubakis IE, Messaritakis I, Kefalogiannis G, Niniraki M, Kouroumalis EA. Measurement of reticulocyte and red blood cell indices in the evaluation of anemia in inflammatory bowel disease. J Crohns Colitis. 2011 Aug;5(4):295-300. doi: 10.1016/j.crohns.2011.02.002.
  • 25. Ipek S, Cekic C, Alper E, Coban E, Eliacik E, Arabul M et al. Can red cell distribution width be a marker of disease activity in ulcerative colitis? Int J Clin Exp Med. 2015 Aug 15;8(8):13848-53.

Can red blood cell distribution width (RDW) predict clinical and endoscopic activity in ulcerative colitis patients?

Year 2020, , 271 - 275, 01.04.2020
https://doi.org/10.28982/josam.712289

Abstract

Aim: Classification of ulcerative colitis (UC) according to disease activity and severity is important in clinical practice for it determines the management of the patient. In this study, we aimed to investigate the relationship between red blood cell distribution width (RDW) and clinical activity index (CAI) in UC patients as well as endoscopic activity indexes (EIA) that determine disease severity relative to mucosal disease.
Methods: This research was planned as a case-control study. Ninety-nine patients diagnosed with UC were divided an active disease group and a remission group according to their clinical and endoscopic findings. Age and gender-matched control groups were formed from 56 individuals with normal colonoscopic findings.
Results: Serum RDW levels were significantly higher in the UC group (P<0.001). In post-hoc comparisons, a statistically significant difference was observed between the control group and active disease groups (P<0.001). However, RDW values did not significantly predict clinical and endoscopic activity in either the active disease or the remission groups (P=0.05 and P=0.09, respectively). In predicting clinical and endoscopic activity indices, the cut-off values of RDW were 14.25 (66% sensitivity and 72% specificity) and 13.75 (64% sensitivity and 62% specificity), respectively.
Conclusion: This study showed that RDW can be used as a marker for disease activity in ulcerative colitis, but it did not show the same efficacy in remission and active disease distinction.

References

  • 1. Lamb CA, Kennedy NA, Raine T, Hendy PA, Smith PJ, Limdi JK, et al. British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut. 2019 Dec;68(Suppl 3): s1-s106. doi:0.1136/gutjnl-2019-3184841
  • 2. Caprilli R, Viscido A, Latella G. Current management of severe ulcerative colitis. Nat Clin Pract Gastroenterol Hepatol. 2007 Feb;4(2):92-101. doi: 10.1038/ncpgasthep0687.
  • 3. Lok KH, Ng CH, Hung HG, Li KF, Li KK, Szeto ML. Correlation of serum biomarkers with clinical severity and mucosal inflammation in Chinese ulcerative colitis patients. J Dig Dis. 2008 Nov;9(4):219-24. doi: 10.1111/j.1751-2980.2008.00350.x.
  • 4. Hassan EA, Ramadan HK, Ismael AA, Mohamed KF, El-Attar MM, Alhelali I. Noninvasive biomarkers as surrogate predictors of clinical and endoscopic remission after infliximab induction in patients with refractory ulcerative colitis. Saudi J Gastroenterol. 2017 Jul-Aug;23(4):238-245. doi: 10.4103/sjg.SJG_599_16.
  • 5. Vermeire S, Van Assche G, Rutgeerts P. Laboratory markers in IBD: useful, magic, or unnecessary toys? Gut. 2006 Mar;55(3):426-31. doi: 10.1136/gut.2005.069476.
  • 6. Karnad A, Poskitt TR. The automated complete blood cell count. Use of the red blood cell volume distribution width and mean platelet volume in evaluating anemia and thrombocytopenia. Arch Intern Med. 1985 Jul;145(7):1270-2. doi: 10.1001/archinte.145.7.1270.
  • 7. Goyal H, Lippi G, Gjymishka A, John B, Chhabra R, May E. Prognostic significance of red blood cell distribution width in gastrointestinal disorders. World J Gastroenterol. 2017 Jul 21;23(27):4879-4891. Doi: 10.3748/wjg.v23.i27.4879.
  • 8. Hammarsten O, Jacobsson S, Fu M. Red cell distribution width in chronic heart failure: a new independent marker for prognosis? Eur J Heart Fail. 2010 Mar;12(3):213-4. doi: 10.1093/eurjhf/hfp208.
  • 9. Chen GP, Huang Y, Yang X, Feng JF. A Nomogram to Predict Prognostic Value of Red Cell Distribution Width in Patients with Esophageal Cancer. Mediators Inflamm. 2015:2015:854670. doi: 10.1155/2015/854670.
  • 10. Celikhisar H, Dasdemir Ilkhan. Comparison of erythrocyte distribution width, mean platelet volume and platelet distribution width in patients with obstructive sleep apnea syndrome. J Surg Med. 2019;3(10):734-9. doi: 10.28982/josam.622377
  • 11. Cakal B, Akoz AG, Ustundag Y, Yalinkilic M, Ulker A, Ankarali H. Red cell distribution width for assessment of activity of inflammatory bowel disease. Dig Dis Sci. 2009 Apr;54(4):842-7. doi: 10.1007/s10620-008-0436-2.
  • 12. Song CS, Park DI, Yoon MY, Seok HS, Park JH, Kim HJ et al. Association between red cell distribution width and disease activity in patients with inflammatory bowel disease. Dig Dis Sci. 2012 Apr;57(4):1033-8. Doi: 10.1007/s10620-011-1978-2. Epub 2011 Dec 7.
  • 13. Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut. 2006 Jun;55(6):749-53. doi: 10.1136/gut.2005.082909.
  • 14. Feagan BG, Greenberg GR, Wild G, Fedorak RN, Paré P, McDonald JW et al. Treatment of ulcerative colitis with a humanized antibody to the alpha4beta7 integrin. N Engl J Med. 2005 Jun 16;352(24):2499-507. doi: 10.1056/NEJMoa042982.
  • 15. Lee JS, Kim ES, Moon W. Chronological Review of Endoscopic Indices in Inflammatory Bowel Disease. Clin Endosc. 2019 Mar;52(2):129-36. doi: 10.5946/ce.2018.042.
  • 16. Rosenberg L, Lawlor GO, Zenlea T, Goldsmith JD, Gifford A, Falchuk KR, et al. Predictors of endoscopic inflammation in patients with ulcerative colitis in clinical remission. Inflamm Bowel Dis. 2013 Mar-Apr;19(4):779-84. doi: 10.1097/MIB.0b013e3182802b0e.
  • 17. D'Haens G, Sandborn WJ, Feagan BG, Geboes K, Hanauer SB, Irvine EJ, et al. A review of activity indices and efficacy end points for clinical trials of medical therapy in adults with ulcerative colitis. Gastroenterology. 2007 Feb;132(2):763-86. doi: 10.1053/j.gastro.2006.12.038.
  • 18. Osada T, Ohkusa T, Okayasu I, Yoshida T, Hirai S, Beppu K, et al. Correlations among total colonoscopic findings, clinical symptoms, and laboratory markers in ulcerative colitis. J Gastroenterol Hepatol. 2008 Dec;23 Suppl 2:S262-7. doi: 10.1111/j.1440-1746.2008.05413.x.
  • 19. Yoon JY, Park SJ, Hong SP, Kim TI, Kim WH, Cheon JH. Correlations of C-reactive protein levels and erythrocyte sedimentation rates with endoscopic activity indices in patients with ulcerative colitis. Dig Dis Sci. 2014 Apr;59(4):829-37. doi: 10.1007/s10620-013-2907-3. Epub 2013 Dec 19.
  • 20. Karoui S, Laz S, Serghini M, Bibani N, Boubaker J, Filali A. Correlation of C-reactive protein with clinical and endoscopic activity in patients with ulcerative colitis. Dig Dis Sci. 2011 Jun;56(6):1801-5. doi: 10.1007/s10620-010-1496-7.
  • 21. Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJ, Pfeffer MA et al. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol. 2007 Jul 3;50(1):40-7. doi: 10.1016/j.jacc.2007.02.067.
  • 22. Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med. 2005 Mar 10;352(10):1011-23. doi: 10.1056/NEJMra041809.
  • 23. Yeşil A, Senateş E, Bayoğlu IV, Erdem ED, Demirtunç R, Kurdaş Övünç AO. Red cell distribution width: a novel marker of activity in inflammatory bowel disease. Gut Liver. 2011 Dec;5(4):460-7. doi: 10.5009/gnl.2011.5.4.460.
  • 24. Oustamanolakis P, Koutroubakis IE, Messaritakis I, Kefalogiannis G, Niniraki M, Kouroumalis EA. Measurement of reticulocyte and red blood cell indices in the evaluation of anemia in inflammatory bowel disease. J Crohns Colitis. 2011 Aug;5(4):295-300. doi: 10.1016/j.crohns.2011.02.002.
  • 25. Ipek S, Cekic C, Alper E, Coban E, Eliacik E, Arabul M et al. Can red cell distribution width be a marker of disease activity in ulcerative colitis? Int J Clin Exp Med. 2015 Aug 15;8(8):13848-53.
There are 25 citations in total.

Details

Primary Language English
Subjects Gastroenterology and Hepatology
Journal Section Research article
Authors

Hüseyin Pülat This is me 0000-0003-0635-3387

Serkan Yalaki 0000-0001-8137-0924

Publication Date April 1, 2020
Published in Issue Year 2020

Cite

APA Pülat, H., & Yalaki, S. (2020). Can red blood cell distribution width (RDW) predict clinical and endoscopic activity in ulcerative colitis patients?. Journal of Surgery and Medicine, 4(4), 271-275. https://doi.org/10.28982/josam.712289
AMA Pülat H, Yalaki S. Can red blood cell distribution width (RDW) predict clinical and endoscopic activity in ulcerative colitis patients?. J Surg Med. April 2020;4(4):271-275. doi:10.28982/josam.712289
Chicago Pülat, Hüseyin, and Serkan Yalaki. “Can Red Blood Cell Distribution Width (RDW) Predict Clinical and Endoscopic Activity in Ulcerative Colitis Patients?”. Journal of Surgery and Medicine 4, no. 4 (April 2020): 271-75. https://doi.org/10.28982/josam.712289.
EndNote Pülat H, Yalaki S (April 1, 2020) Can red blood cell distribution width (RDW) predict clinical and endoscopic activity in ulcerative colitis patients?. Journal of Surgery and Medicine 4 4 271–275.
IEEE H. Pülat and S. Yalaki, “Can red blood cell distribution width (RDW) predict clinical and endoscopic activity in ulcerative colitis patients?”, J Surg Med, vol. 4, no. 4, pp. 271–275, 2020, doi: 10.28982/josam.712289.
ISNAD Pülat, Hüseyin - Yalaki, Serkan. “Can Red Blood Cell Distribution Width (RDW) Predict Clinical and Endoscopic Activity in Ulcerative Colitis Patients?”. Journal of Surgery and Medicine 4/4 (April 2020), 271-275. https://doi.org/10.28982/josam.712289.
JAMA Pülat H, Yalaki S. Can red blood cell distribution width (RDW) predict clinical and endoscopic activity in ulcerative colitis patients?. J Surg Med. 2020;4:271–275.
MLA Pülat, Hüseyin and Serkan Yalaki. “Can Red Blood Cell Distribution Width (RDW) Predict Clinical and Endoscopic Activity in Ulcerative Colitis Patients?”. Journal of Surgery and Medicine, vol. 4, no. 4, 2020, pp. 271-5, doi:10.28982/josam.712289.
Vancouver Pülat H, Yalaki S. Can red blood cell distribution width (RDW) predict clinical and endoscopic activity in ulcerative colitis patients?. J Surg Med. 2020;4(4):271-5.