Microinflammation in patients with Crohn's disease in clinical remission.

BACKGROUND AND AIMS It is not clear whether Crohn's disease patients in clinical remission (Crohn's disease activity index<150) display normal concentrations of inflammation sensitive biomarkers. Our goal in this work was to explore the intensity of the microinflammatory response in a group of Crohn's disease patients in clinical remission. METHODS High sensitivity C-reactive protein, quantitative fibrinogen, erythrocyte sedimentation rate as well as platelet and leukocyte counts were examined in a group of 76 patients with Crohn's disease in remission and in 228 matched controls. RESULTS Crohn's disease patients in clinical remission displayed a statistically significant (p<0.001) elevated concentration of hs-CRP (4.83±3.8 mg/l) compared to controls (1.05±2.9 mg/l). All other bio-markers were also significantly higher in Crohn's disease patients in remission compared to controls. Similar results were obtained in a subgroup of Crohn's disease patients with very low disease activity - CDAI<75. CONCLUSIONS Clinical remission is not equivalent to biochemical remission raising a question concerning the true definition of remission in Crohn's disease.