Correlation of Clinical, Endoscopic and Histopathological Activity in Ulcerative Colitis: A Cross-sectional Analysis
Correspondence Address :
Dr. Janaky Ramakrishnan,
Assistant Professor, Department of Pathology, KMCT Medical College, Mukkam, Calicut-673602, Kerala, India.
E-mail: janakyram87@gmail.com
Introduction: There are several scoring systems in use to determine the endoscopic, clinical and histopathological activity in Ulcerative Colitis (UC) which helps in defining the optimal management strategy.
Aim: To understand the correlation between histological activity with simplified Geboes Score (GS), clinical activity with Truelove and Witts Score (TLWS) and endoscopic activity with Mayo Endoscopic Score (MES) in UC. The study also aimed at describing the common histopathological features of UC.
Materials and Methods: A cross-sectional analysis was conducted at a tertiary care hospital in Southern India for 1.5 years (November 2014 to May 2016). Consecutive colonoscopy biopsies of patients who presented with lower gastrointestinal symptoms and endoscopic findings suggestive of UC were included. Baseline characteristics including age, gender, symptoms, clinical signs and extent of disease were recorded. Disease severity was graded using TLWS, MES using endoscopy and GS. Spearman’s correlations between the MES, GS and TLWS were calculated.
Results: A total of 62 cases of clinically diagnosed UC patients were evaluated based on endoscopy and histopathology findings. The mean age was 44.7 years and 42 (67.74%) were males in the study. Proctosigmoiditis was the most common extent (32.25%), followed by cases of proctitis (25.80%), pancolitis (22.58%), and left sided colitis (14.51%). There was a strong correlation between MES/TLWS with a rho=0.614 (p<0.001), followed by MES/GS with rho=0.421 (p<0.001) and GS/MES with a rho=0.375 (p<0.01). Basal plasmacytosis was found in 92.86% of moderate to severe disease.
Conclusion: The GS system strongly correlates with both MES and TWLS in patients with UC which could be used concurrently to determine the extent of healing and optimise treatment strategy. Findings of basal plasmacytosis, mucin depletion, dysplasia and pseudopolyps are associated with moderate to severe disease activity.
Colitis, Crohn’s disease, Goebes score, Mayo endoscopic score, Truelove and witts score
10.7860/JCDR/2021/50057.15609
Date of Submission: May 02, 2021
Date of Peer Review: Jun 29, 2021
Date of Acceptance: Aug 21, 2021
Date of Publishing: Nov 01, 2021
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
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• iThenticate Software: Sep 10, 2021 (10%)
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