Emrullah Erdem

Red cell distribution width: a novel marker of activity in inflammatory bowel disease.

Background/Aims Studies concerning red cell distribution width (RDW) for use in the assessment of inflammatory bowel disease (IBD) activity are limited. We investigated whether RDW is a marker of active disease in patients with IBD. Methods In total, 61 patients with ulcerative colitis (UC) and 56 patients with Crohns disease (CD) were enrolled in the study group, and 44 age- and-sex-matched healthy volunteers were included as the control group. A CD activity index >150 in patients with CD indicated active disease. Patients with moderate and severe disease based on the Truelove-Witts criteria were considered to have active UC. In addition to RDW, serum C-reactive protein levels, erythrocyte sedimentation rates, and platelet counts were measured. Results Twenty-nine (51.7%) patients with CD and 35 (57.4%) patients with UC had active disease. The RDW was significantly higher in patients with CD and UC than in controls (p<0.001 and p<0.001, respectively). A subgroup analysis indicated that for a RDW cut-off of 14%, the sensitivity for detecting active CD was 79%, and the specicity was 93% (area under curve [AUC], 0.935; p<0.001). RDW was the most sensitive and specific marker for active CD. However, it was not valid for UC, as the ESR at a cutoff of 15.5 mm/hr showed a sensitivity of 83% and a specicity of 76% (AUC, 0.817; p<0.001), whereas the RDW at a cutoff of 14% showed 17% sensitivity and 84% specicity for detecting active UC. Conclusions RDW was elevated in IBD in comparison with healthy controls and increased markedly in active disease. RDW may be a sensitive and specific marker for determining active CD, whereas ESR is an important marker of active UC.

Serum anti-Müllerian hormone levels are lower in reproductive-age women with Crohn's disease compared to healthy control women

BACKGROUND AND AIM Crohns disease (CD) decreases fertility both directly, by inducing inflammation in the fallopian tubes and ovaries, and indirectly, through the surgical interventions and tubal adhesions associated with disease treatment. Anti-müllerian hormone (AMH) is a reliable indicator of ovarian reserve in women. We aimed to compare serum AMH levels between reproductive-age women with CD and healthy controls. METHODS Serum AMH levels were measured by ELISA in 35 women with CD and 35 age-matched healthy women controls. RESULTS CD patients and controls were similar in terms of age, height, weight and BMI. Mean CD duration was 60 months. CRP, ESR and leukocyte counts were significantly higher in CD patients compared to the controls (p<0.001, p=0.004 and p=0.04, respectively). AMH levels in CD patients (1.02 ± 0.72) were significantly lower compared to the controls (1.89 ± 1.80) (p = 0.009). Serum AMH levels in CD patients with active disease (0.33 ± 0.25) were significantly lower compared to CD patients who were in remission (1.53 ± 0.49) (p = 0.001). Serum AMH levels were similar in CD patients with a disease duration of less than 5 years (17 patients) and CD patients with a disease duration of greater than 5 years (18 patients) (p = 0.8). In CD patients, a negative correlation between CDAI and serum AMH levels was found (r = -0.718, p < 0.001). Serum AMH levels were similar in CD patients who had (6 patients) and had not undergone (29 patients) surgical treatment (p = 0.2). CONCLUSION Serum AMH levels of reproductive-age women with CD were significantly lower compared to the controls. CDAI and AMH are inversely correlated.

High treatment modification rates with lamivudine therapy in HBV‐infected patients with low baseline viremia and early virological response: A multicenter study

Low baseline viremia and an early treatment response predict the best outcomes in hepatitis B virus (HBV)‐infected patients treated with nucleoside analogues with low barriers to resistance. The aim of this study was to assess the long‐term results and effectiveness of lamivudine in patients with low baseline viremia and early virological treatment response.

Inflamatuvar barsak hastalıklarının aktivite tayininde endoskopik aktivite indeksleri ile laboratuvar parametreleri arasındaki ilişki

Inflamatuvar barsak hastaliklari genetik olarak yatkin kisilerde, nedeni ve mekanizmasi tam olarak bilinmeyen, kronik seyirli, remisyon ve alevlenme donemleriyle karakterize inflamatuvar bir hastalik grubudur. Ulseratif kolit ve Crohn hastaligi olmak uzere iki onemli hastaligi icermektedir. Bu hastalarda; hastalik aktivitesinin degerlendirilmesi, tedavinin sekillendirilmesi icin bircok klinik aktivite gostergeci ve non invaziv belirtec kullanilmis, fakat hicbiri inflamatuvar aktivitenin saptanmasinda histopatolojik ve endoskopik incelemeler kadar kesin bulgu vermemistir. Inflamatuvar barsak hastaliklarinda aktivitenin belirlenmesi amaci ile ulseratif kolit icin yaygin kullanim bulan klinik indeksler; Truelove-Witts ve Rachmilewitz klinik aktivite indeksidir. Crohn hastaliginda ise tum dunyada kabul edilen klinik indeks Crohn hastaligi aktivite indeksidir. Endoskopik indeksler icerisinde; ulseratif kolit icin endoskopik Mayo Skoru ve Crohn hastaligi icin basit endoskopik skor yaygin kullanim alani bulmus indekslerdir. Biz bu calismada yaygin kullanilan bu aktive indeksleriyle gunluk pratigimizde sik kullandigimiz laboratuvar parametrelerini karsi-lastirdik. Bu amacla inflamatuvar barsak hastaliklari klinik ve endoskopik takibinde bu parametrelerin degerini arastirdik.