P205 Eliakim and CECDAIic scores are useful pan-intestinal tools for CD diagnosis and activity monitoring
Freitas, M.(1,2,3);Capela, T.(1,2,3);Macedo Silva, V.(1,2,3);Arieira, C.(1,2,3);Xavier, S.(1,2,3);Cúrdia Gonçalves, T.(1,2,3);Boal Carvalho, P.(1,2,3);Dias de Castro, F.(1,2,3);Rosa, B.(1,2,3);Moreira, M.J.(1,2,3);Cotter, J.(1,2,3);
(1)Hospital da Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal;(2)PT Government Associate Laboratory, ICVS/3B’s, Braga/Guimarães, Portugal;(3)School of Medicine- University of Minho, Life and Health Sciences Research Institute ICVS, Braga, Portugal;
Background
Capsule endoscopy is a valuable tool in the diagnosis and monitoring of Crohn’s disease (CD). Recently, a new panenteric capsule (pan-CE), PillCam Crohn’s (Medtronic, USA) was approved. A novel quantitative score of inflammation for PillCam Crohn’s, the Eliakim score, has emerged. However, the optimal index for panenteric monitoring disease activity is far from being completely defined. We aimed to evaluate the correlation and accuracy between the pan-CE Eliakim and capsule endoscopy Crohn’s disease activity index (CECDAIic) scores and inflammatory parameters.
Methods
Retrospective study, including a cohort of consecutive patients with suspected or established CD that underwent Pan-CE PillCam Crohn’s over 4 years. The Eliakim and CECDAIic scores were calculated. Spearman correlation (rs) was used to access the correlation between the scores and inflammatory biomarkers.
Results
Thirty-two patients were included, 71.9% females, with mean age of 35±13 years, 59.4% with suspected CD. The median Eliakim and CECDAIic scores were 5.5 (0-13) and 6.5 (0-15.5), respectively. The diagnosis of CD was established in 31.6% of patients with suspected CD. We found a very good correlation between Eliakim and CECDAIic scores (rs=0.87; p<0.001), and a moderate correlation between Eliakim and CECDAIic scores with C-reactive protein (rs=0.53; p=0.003), (rs=0.44; p=0.02), and fecal calprotectin (rs=0.46; p=0.02), (rs=0.54; p=0.01), respectively. In patients with suspected CD, an Eliakim ≥3.5 and CECDAIic score ≥5.5 had a sensitivity of 100%, and specificity of 84.6%, and 75.0%, respectively, for the diagnosis of CD.
Conclusion
The Eliakim and CECDAIic scores have a strong correlation in assessing panenteric CD activity, and a moderate correlation with inflammatory biomarkers. The application of Eliakim ≥3.5 and CECDAIic score ≥5.5 as the cutoff values for the presence of significant inflammatory activity in patients undergoing pan-CE for suspected CD may be useful to establish the diagnosis.