Digestive Diseases and Sciences

, Volume 52, Issue 9, pp 2063–2068

CRP Correlates with Clinical Score in Ulcerative Colitis but Not in Crohn’s Disease

Original Paper


The aim of this study was to prospectively evaluate the correlation between clinical scoring systems and C-reactive protein (CRP) in inflammatory bowel disease. The modified Harvey-Bradshaw index was used in 40 patients (58 assessments) with Crohn’s disease, and the Lichtiger score in 29 patients (36 assessments) with ulcerative colitis. In ulcerative colitis, CRP was elevated in 14%, 42%, 64%, and 83%, respectively, of subjects with quiescent, mild, moderate, and severe disease. There was a linear correlation of log(CRP) with clinical score except for proctitis. In Crohn’s disease, CRP was elevated in 54%, 70%, 75%, and 100%, respectively, of subjects with quiescent, mild, moderate, and severe disease. We conclude that the clinical score has a good correlation with CRP in ulcerative colitis except for proctitis, whereas clinical score has a poor correlation with CRP in Crohn’s disease, particularly in those with clinically quiescent, fibrostenotic, and ileal disease.


C-reactive protein Crohn’s disease Erythrocyte sedimentation rate Inflammatory bowel disease Ulcerative colitis 


  1. 1.
    Camilleri M, Proana M (1989) Advances in the assessment of disease activity in inflammatory bowel disease. Mayo Clin Proc 64:800–807PubMedGoogle Scholar
  2. 2.
    Gomes P, du Boulay C, Smith CL, Holdstock G (1986) Relationship between disease activity indices and colonoscopic findings in patients with colonic inflammatory bowel disease. Gut 27:92–95PubMedGoogle Scholar
  3. 3.
    Saverymuttu SH, Camilleri M, Rees H, Lavender JP, Hodgson HJF, Chadwick VS (1986) Indium 111-granulocyte scanning in the assessment of disease extent and disease activity in inflammatory bowel disease: a comparison with colonoscopy, histology, and fecal indium 111-granulocyte excretion. Gastroenterology 90:1121–1128PubMedGoogle Scholar
  4. 4.
    Papi C, Ciaco A, Bianchi M, Montani S, Koch M, Capurso L (1996) Correlation of various Crohn’s disease activity indexes in subgroups of patients with primarily inflammatory or fibrostenosing clinical characteristics. J Clin Gastroenterol 23:40–43PubMedCrossRefGoogle Scholar
  5. 5.
    Sachar DB, Smith H, Chan S, Cohen LB, Lichtiger S, Messer J (1986) Erythrocyte sedimentation rate as a measure of clinical activity in inflammatory bowel disease. J Clin Gastroenterol 8:647–650PubMedCrossRefGoogle Scholar
  6. 6.
    Prantera C, Davoli M, Lorenzetti R, Pallone F, Marcheggiano A, Iannoni C, Mariotti S (1988) Clinical and laboratory indicators of extent of ulcerative colitis. Serum C-reactive protein helps the most. J Clin Gastroenterol 10:41–45PubMedCrossRefGoogle Scholar
  7. 7.
    Fagan EA, Dyck RF, Maton PN, Hodgson HJF, Chadwick VS, Petrie A, Pepys MB (1989) Serum levels of C-reactive peptide in Crohn’s disease and ulcerative colitis. Eur J Clin Invest 12:351–359CrossRefGoogle Scholar
  8. 8.
    Sachar DB, Luppescu NE, Bodian C, Shlien RD, Fabry TL, Gumaste VV (1990) Erythrocyte sedimentation as a measure of Crohn’s disease activity: opposite trends in ileitis versus colitis. J Clin Gastroenterol 12:643–646PubMedCrossRefGoogle Scholar
  9. 9.
    Best WR, Becktel JM, Singleton JW, Kern Jr F (1976) Development of a Crohn’s disease activity index: National Cooperative Crohn’s Disease Study. Gastroenterology 70:439–444PubMedGoogle Scholar
  10. 10.
    Lichtiger S, Present DH, Kornbluth A, Gelernt I, Bauer J, Galler G, Michelassi F, Hanauer S (1994) Cyclosporine in severe ulcerative colitis refractory to steroid therapy. N Engl J Med 330:1841–1845PubMedCrossRefGoogle Scholar
  11. 11.
    Harvey RF, Bradshaw JM (1980) A simple index of Crohn’s disease activity. Lancet 1:514PubMedCrossRefGoogle Scholar
  12. 12.
    Talstad I, Gjone E (1976) The disease activity of ulcerative colitis and Crohn’s disease. Scand J Gastroenterol 11:403–408PubMedGoogle Scholar
  13. 13.
    Dearing WH, McGuckin WH, Elveback LR (1986) Serum alpha 1-acid glycoprotein in chronic ulcerative colitis. Gastroenterology 56:295–303Google Scholar
  14. 14.
    Cooke WT, Prior P (1984) Determining disease activity in inflammatory bowel disease. J Clin Gastroenterol 6:17–25PubMedGoogle Scholar
  15. 15.
    Talstasd I, Gjone E (1976) The disease activity of ulcerative colitis and Crohn’s disease. Scand J Gastroenterol 11:403–408Google Scholar
  16. 16.
    Florin TH, Paterson EW, Fowler EV, Radford-Smith GL (2006) Clinically active Crohn’s disease in the presence of a low C-reactive protein. Scand J Gastroenterol 41:306–311PubMedCrossRefGoogle Scholar
  17. 17.
    Savermyuttu SH, Hodgson HJF, Chadwick VS, Pepys MB (1986) Differing acute phase responses in Crohn’s disease and ulcerative colitis. Gut 27:809–813Google Scholar
  18. 18.
    Vermeire S, Van Assche G, Rutgeerts P (2006) Laboratory markers in IBD: Useful magic, or unnecessary toys? Gut 55:426–432PubMedCrossRefGoogle Scholar
  19. 19.
    Chamouard P, Richert Z, Meyer N, Rahmi G, Bauman R (2006) Diagnostic value of C-reactive protein for predicting activity level of Crohn’s disease. Clin Gastroenterol Hepatol 4:882–887PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  1. 1.Department of Gastroenterology and HepatologyThe Queen Elizabeth HospitalWoodville SouthAustralia

Personalised recommendations