Clinical and endoscopic parallels in ulcerative colitis
Background. Currently, there is no ideal way to assess the activity of ulcerative colitis (UC), which determines the relevance of studying the characteristics of the course of this pathology with a comparative analysis of typical clinical and endoscopic manifestations. The purpose is to optimize the diagnosis of UC. Materials and methods. Sixty patients with a confirmed diagnosis of UC were examined, 31 (51.7 %) men and 29 (48.3 %) women aged 21 to 63 years (the average age was (40.28 ± 21.34) years), among them — 52 (86.6 %) persons of working age. Results. The distribution of patients according to the Mayo combined index showed that 36 (60.0 %) individuals had a moderate degree of UC exacerbation, the average indicator was (8.12 ± 0.29) points; in 24 (40.0 %) cases, a severe degree was diagnosed, the average value of the index was (11.38 ± 0.48) points. Correlation analysis of UC activity indices showed a correlation between the degree of disease activity according to the Mayo combined index and clinical activity according to the D. Rachmilewitz scale (r = 0.459; p < 0.01), and the severity of UC flare-up according to S. Truelove and L. Witts criteria (r = 0.526; p < 0.01) and endoscopic activity — to the partial Mayo score (r = 0.598; p < 0.01). Conclusions. The established clinical and endoscopic relationships in UC confirm the need for an integrated approach to the diagnosis of this disease. Given that the degree of spread of inflammation and the severity of UC flare-up affect patient’s management and the evaluation of therapeutic interventions, clinical and endoscopic indicators are useful for standardizing disease activity.
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Stepanov YuM, Skirda IYu, Petishko OP. Chronic inflammatory bowel diseases: epidemiological features in Ukraine. Gastroenterologìa. 2017;51(2):97-105. doi: 10.22141/2308-2097.51.2.2017.101703. (in Ukrainian).
Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2018 Dec 23;390(10114):2769-2778. doi: 10.1016/S0140-6736(17)32448-0.
Kaplan GG, Ng SC. Globalisation of inflammatory bowel disease: perspectives from the evolution of inflammatory bowel disease in the UK and China. Lancet Gastroenterol Hepatol. 2016 Dec;1(4):307-316. doi: 10.1016/S2468-1253(16)30077-2.
Glavnov PV, Lebedeva NN, Kashchenko VA, Varzin SA. Ulcer colitis and Crohn's disease. Current state of a problem of an etiology, early diagnosis and treatment (literature review). Vestnik Sankt-Peterburgskogo universiteta. Medicina. 2015;(4):48-72. (in Russian).
Sturm A, Maaser C, Calabrese E, et al. ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 2: IBD scores and general principles and technical aspects. J Crohns Colitis. 2019 Mar 26;13(3):273-284. doi: 10.1093/ecco-jcc/jjy114.
Maaser C, Sturm A, Vavricka SR, et al. ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications. J Crohns Colitis. 2019 Feb 1;13(2):144-164. doi: 10.1093/ecco-jcc/jjy113.
Magro F, Gionchetti P, Eliakim R, et al. Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis. Part 1: Definitions, Diagnosis, Extra-intestinal Manifestations, Pregnancy, Cancer Surveillance, Surgery, and Ileo-anal Pouch Disorders. J Crohns Colitis. 2017 Jun 1;11(6):649-670. doi: 10.1093/ecco-jcc/jjx008.
Stepanov JuM, Symonova OV. Characterization of the endoscopic picture of the colon in patients with ulcerative colitis, depending on gender and age characteristics. Medicni perspektivi. 2018;23(2-1):118. (in Ukrainian).
Mohammed Vashist N, Samaan M, Mosli MH, et al. Endoscopic scoring indices for evaluation of disease activity in ulcerative colitis. Cochrane Database Syst Rev. 2018 Jan 16;1:CD011450. doi: 10.1002/14651858.CD011450.pub2.
Silverberg MS, Satsangi J, Ahmad T, et al. Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a working party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroenterol. 2005 Sep;19 Suppl A:5A-36A. doi: 10.1155/2005/269076.
Rachmilewitz D. Coated mesalazine (5-aminosalicylic acid) versus sulphasalazine in the treatment of active ulcerative colitis: a randomised trial. BMJ. 1989 Jan 14;298(6666):82-6. doi: 10.1136/bmj.298.6666.82.
Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N Engl J Med. 1987 Dec 24;317(26):1625-9. doi: 10.1056/NEJM198712243172603.
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