The subpopulations of circulating white blood cells in inflammatory bowel disease.

A detailed analysis of the species of lymphocytes was carried out in 58 patients with inflammatory bowel disease (IBD). These individuals were further divided into 31 with Crohn's disease (CD) and 27 with ulcerative colitis (UC). There were 13 CD patients with only small bowel involvement called "regional enteritis" and 18 who had some degree of colonic involvement called "ileocolitis". Similarly, the UC group was subdivided into 9 patients with disease confined to the rectosigmoid area called "proctosigmoiditis" and 18 with more extensive involvement called "universal colitis". We also studied 13 patients who had undergone previous colectomy and ileostomy and 78 healthy age- and sex-matched controls. Although there was no increase in the absolute number of lymphocytes in patients with ileocolitis and universal colitis, the percentage of these cells was decreased because of an increase in both polymorphonuclear leukocytes and monocytes. In IBD and its subgroups, mean T lymphocytes, determined by the sheep red blood cell rosette technique, were not significantly different from the controls either in percentage or absolute number. Furthermore, no difference was noted between UC and CD. However, there seems to be a subpopulation of patients with UC or CD whose T cells are reduced below 1 SD of the mean. There was also no difference in the number of immunoglobulin-bearing B cells in both diseases; however, when the B cells were enumerated by their ability to rosette with antibody-complement-coated sheep cells (EAC), we found a marked decrease in percentage (P less than 0.001) and absolute number (P less than 0.0005) relative to the control population. The decrease bore a direct relation to the severity of the disease process and, although more marked in patients with UC, was present in CD also.