Crohn's & colitis 360 · 2026
Association between serum leucine-rich alpha-2-glycoprotein levels and characteristic enteroclysis findings in small intestinal Crohn's disease.
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Fukata Masayuki, Kikuta Shu, Okayama Kazuyo, Sonoda Akira, Okano Soh, Unuma Kiyohito
Аннотация
INTRODUCTION: Enteroclysis provides a whole picture of mucosal and wall-structural information that is advantageous in assessing small intestinal Crohn's disease (CD). Leucine-rich alpha-2-glycoprotein (LRG) is an acute-phase protein that has been shown to be increased in active CD. We sought to explore the association of LRG with the presence of typical CD findings in enteroclysis.
METHODS: Patients with small intestinal CD whose serum LRG and C-reactive protein (CRP) were measured within 30 days before or after enteroclysis were selected, and were categorized by the presence of longitudinal ulcer, cobblestone appearance, and stricture/narrowing. Levels of LRG were compared by the type and the extent of lesions. Detection performances of LRG and CRP were compared for the presence of each type of lesion.
RESULTS: Serum LRG levels were significantly higher in patients who had enteroclysis findings than patients with no findings (23.5 ± 9.2 vs. 12.8 ± 3.0 μg/dL, P < .00001). The level of LRG was not affected by disease extent or history of bowel resection. LRG over 16.3 μg/dL had good detection accuracy for the presence of CD lesions with an area under the receiver operating characteristic curve of 0.85 (95% confidence interval: 0.75-0.95). The association of LRG with the presence of CD-specific lesions was significantly higher than CRP, especially for the presence of stricture/narrowing (AUC: 0.82 vs. 0.67, P = .005) and longitudinal ulcer (AUC: 0.93 vs. 0.80, P = .017).
CONCLUSION: Elevation of serum LRG is associated with the presence of typical CD lesions in the small intestine that may be found in entericlysis.
METHODS: Patients with small intestinal CD whose serum LRG and C-reactive protein (CRP) were measured within 30 days before or after enteroclysis were selected, and were categorized by the presence of longitudinal ulcer, cobblestone appearance, and stricture/narrowing. Levels of LRG were compared by the type and the extent of lesions. Detection performances of LRG and CRP were compared for the presence of each type of lesion.
RESULTS: Serum LRG levels were significantly higher in patients who had enteroclysis findings than patients with no findings (23.5 ± 9.2 vs. 12.8 ± 3.0 μg/dL, P < .00001). The level of LRG was not affected by disease extent or history of bowel resection. LRG over 16.3 μg/dL had good detection accuracy for the presence of CD lesions with an area under the receiver operating characteristic curve of 0.85 (95% confidence interval: 0.75-0.95). The association of LRG with the presence of CD-specific lesions was significantly higher than CRP, especially for the presence of stricture/narrowing (AUC: 0.82 vs. 0.67, P = .005) and longitudinal ulcer (AUC: 0.93 vs. 0.80, P = .017).
CONCLUSION: Elevation of serum LRG is associated with the presence of typical CD lesions in the small intestine that may be found in entericlysis.