Clinical, Biological, and Histologic Parameters as Predictors of Relapse in Ulcerative Colitis

abstract & commentary

Synopsis: Relapses of ulcerative colitis are common and may be predictable. Risk factors include youth, frequency of prior relapses, and increased plasma cells in rectal biopsies.

Source: Bitton A, et al. Gastroenterology 2001;120:13-20.

Ulcerative colitis is a disorder that commonly relapses, but exacerbations have not been predictable clinically. Bitton and colleagues find that younger age, multiple prior relapses (for women), and basal plasmacytosis on biopsies of the colon seem to predict early relapse. This could help optimize medical management of ulcerative colitis patients.

Seventy-four patients were closely monitored for up to a year (less if earlier relapse occurred). A variety of clinical and laboratory measures were collected.

Twenty-seven patients relapsed (19/42 women and 8/32 men). Risk factors for early relapse appeared to include younger age, more prior relapses (significant only in the women), and basal plasmacytosis on rectal biopsy.

Comment by Malcolm Robinson, MD, FACP, FACG

Ulcerative colitis is difficult to manage, and it is clear that some patients will require particularly aggressive intervention to achieve and maintain remission. Know-ledge of the most important factors that might signal a particularly high risk of relapse could guide more "advanced" therapy to those patients most likely to benefit.