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. 2019 Nov 7:14:785-791.
doi: 10.1515/med-2019-0092. eCollection 2019.

Lemann Index for Assessment of Crohn's Disease: Correlation with the Quality of Life, Endoscopic Disease Activity, Magnetic Resonance Index of Activity and C- Reactive Protein

Vestina Straksyte  1 , Gediminas Kiudelis  2 , Irina Gineikiene  1 , Dainius Janciauskas  3 , Algidas Basevicius  1 , Saulius Lukosevicius  1 , Limas Kupcinskas  2
Affiliations

Lemann Index for Assessment of Crohn's Disease: Correlation with the Quality of Life, Endoscopic Disease Activity, Magnetic Resonance Index of Activity and C- Reactive Protein

Vestina Straksyte et al. Open Med (Wars). .

Abstract

Aim: Crohn's disease (CD) is characterized by continuing inflammation and progressive gut damage. Despite many scoring indices of CD, there is a lack of more global assessment tools for the evaluation of the total disease impact on the gut.

Methods: Fift y-three adult patients with proven CD underwent magnetic resonance enterocolonography (MR-EC), colonoscopy, and clinical activity assessment, including CRP. Quality of life was assessed using IBDQ. MR-EC was used to evaluate the Magnetic Resonance Index of Activity (MaRIA- global (G)) and the Lemann Index (LI). The CD Endoscopic Index of Severity (CDEIS) was used to score the endoscopic activity of the disease.

Results: A signifi cant correlation between the LI and IBDQ was found (r=-0.812, P<0.01). LI and MaRIA-G correlated moderately, while the LI did not correlate significantly with CRP and CDEIS. For the detection of endoscopically active CD, MaRIA-G was more sensitive and specific (83.3%; 73.3%) compared to the LI (66.7%; 60.0%). There was a moderate correlation between CRP and MaRIA-G, as well as CRP and CDEIS (r=0.496; r=0.527,<0.01).

Conclusion: A signifi cant negative correlation between the LI and quality of life, measured by IBDQ, was found in our study, suggesting that the LI could resemble more global features of the disease, besides inflammatory activity of the gut.

Keywords: Crohn’s disease; Lemann index; Magnetic resonance enterocolonography; Quality of life.

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Conflict of interest statement

Conflicts of interest The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of patient enrollment, exclusion criteria, and final study population. Abbreviations: CD– Crohn’s disease; CDEIS– Crohn's Disease Endoscopic Index of Severity; IBDQ– inflammatory bowel disease questionnaire; LI– Lemann Index; MaRIA-G– Magnetic Resonance Index of Activity Global; MR-EC –Magnetic Resonance Enterocolonography.
Figure 2
Figure 2
ROC curve analysis of MR-EC in predicting endoscopic Crohn’s disease activity.
Figure 3
Figure 3
Correlation of Lemann Index and the Inflammatory Bowel Disease Questionnaire.
Figure 4
Figure 4
Correlation of Lemann Index and Magnetic Resonance Index of Activity Global.
Figure 5
Figure 5
The sensitivity and specificity of Magnetic Resonance Index of Activity Global and the Lemann Index in detecting active Crohn’s Disease at endoscopy (Crohn’s Disease Endoscopic Index of Severity ≥ 9, P<0.01).
Figure 6A
Figure 6A
Correlation between CRP and Magnetic Resonance Index of Activity Global. Abbreviations: CDEIS– Crohn’s Disease Endoscopic Index of Severity; CRP- C-reactive protein.
Figure 6B
Figure 6B
Correlation between CRP and Crohn’s Disease Endoscopic Index of Severity. Abbreviations: CDEIS– Crohn’s Disease Endoscopic Index of Severity; CRP- C-reactive protein.
See this image and copyright information in PMC

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