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Relationship between intestinal permeability to [51Cr]EDTA and inflammatory activity in asymptomatic patients with Crohn's disease

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Abstract

The relationship between intestinal permeability to an oral dose (100 μCi) of [51CR]EDTA and the inflammatory activity of Crohn's disease was studied in 63 adult patients (32 unresected and 31 resected) who underwent 162 evaluations. The results of the [51CR]EDTA test were compared with the serum levels of the acute-phase reactant proteins (APRP) and with the result of the [111In]leukocyte scanning, respectively, as an indirect and direct method to assess intestinal inflammation. In a group of healthy adult controls, the upper normal value for the 24-hr urinary [51CR]EDTA excretion was 3.61 (97.5 percentile) and the mean coefficient of variation was 21%. Sensitivity and specificity of the [51CR]EDTA test in identifying active inflammation expressed by increased serum levels of APRP were, respectively, 97% and 54% in the unresected group and 68% and 52% in the resected group of patients. The low specificity of the test was due to the presence of increased [51CR]EDTA urinary excretion in about half the cases with normal serum levels of APRP. The [111In] leukocyte scanning was performed in a subgroup of 11 patients (three unresected and eight resected) with normal serum levels of APRP, six with increased and five with normal [51CR]EDTA urinary excretion. All six patients with increased intestinal permeability had a positive111In image of mild to moderate degree of activity. A positive111In scan was present in two of the five patients with normal permeability; these were two resected patients. We conclude that in patients with Crohn's disease in remission, increased [51CR]EDTA urinary excretion can be considered an indirect sign of active inflammation, with a sensitivity greater than the serum levels of the APRP for the presence of intestinal areas of inflammation of mild to moderate degree.

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Authors and Affiliations

  1. Department of Internal Medicine and Gastroenterology, University of Bologna, S. Orsola Hospital, V. Massarenti 9, 40138, Bologna, Italy

    Loris Pironi MD, Mario Miglioli MD, Enrico Ruggeri MD, Maurizio Levorato MD, Maria Angela Dallasta MD, Claudio Corbelli MD, Maria Grazia Nibali MD & Luigi Barbara MD

  2. Nuclear Medicine Service, S. Orsola-Malpighi Hospital, Bologna, Italy

    Loris Pironi MD, Mario Miglioli MD, Enrico Ruggeri MD, Maurizio Levorato MD, Maria Angela Dallasta MD, Claudio Corbelli MD, Maria Grazia Nibali MD & Luigi Barbara MD

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  1. Loris Pironi MD
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  2. Mario Miglioli MD
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  8. Luigi Barbara MD
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Pironi, L., Miglioli, M., Ruggeri, E. et al. Relationship between intestinal permeability to [51Cr]EDTA and inflammatory activity in asymptomatic patients with Crohn's disease. Digest Dis Sci 35, 582–588 (1990). https://doi.org/10.1007/BF01540405

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  • DOI: https://doi.org/10.1007/BF01540405

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