Abstract
A number of investigators have assessed the activity of IBD through the fecal clearance of α1,-AT.α1-AT is a serine protease inhibitor present in the α1-globulin fraction of blood. In our investigations in IBD, we have found that the simple and rapid determination of serum α-AT alone gave a useful measure of disease activity. We compared the sensitivity and specificity of serum α1-AT levels versus ESR's in 1)the initial diagnosis of IBD and 2)the evaluation of disease activity in patients with known IBD. Serum α1-AT was measured by radial immunodiffusion (elevated >350 ug/dl), and ESR by the Westergren method (elevated >20 mm/hr). Diagnosis and disease activity was determined by accepted clinical, endoscopic, radiologic, and histologic methods.
For the initial presentation (1), α1-AT was elevated in 93% of patients vs 53% with elevated ESR. Both tests were relatively specific (92% vs 100%) for patients without IBD. In the evaluation of disease activity, α1-AT was elevated 98% of the time vs 59% for ESR during active disease. Both were normal in inactive disease. Analysis with respect to sex or IBD-type (U.C. vs Crohn's) yielded similar findings.
Conclusions: Serum α1-AT is a better indicator of IBD activity than the commonly used ESR. We suggest that α1-AT determination be used both in the diagnosis and follow-up of patients with IBD.
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Pettei, M., Levlne, J. & Davidson, M. SERUM α1-ANTITRYPSIN (α1-AT) LEVELS AS A MARKER OF ACTIVITY IN INFLAMMATORY BOWEL DISEASE (IBD). Pediatr Res 21 (Suppl 4), 275 (1987). https://doi.org/10.1203/00006450-198704010-00648
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DOI: https://doi.org/10.1203/00006450-198704010-00648