BACKGROUND/AIMS: Small bowel capsule endoscopy (SBCE) is used to visualize mucosal inflammatory changes in the small intestine of patients with Crohn's disease (CD). The Lewis score (LS) and Capsule Endoscopy Crohn's Disease Activity Index (CECDAI) are used to evaluate the visualized images. We determined the score disagreement between LS and CECDAI in patients with CD. METHODS: We evaluated 184 SBCE procedures in 102 CD patients with small bowel lesions. Patients were classified according to the Montreal classification. LS and CECDAI were calculated, and cases with disagreement between the two scores were identified. We investigated the characteristics of disagreement, and analyzed the relationships with the Crohn's Disease Activity Index (CDAI) and C-reactive protein. RESULTS: LS (504 ± 1160) correlated strongly with CECDAI (6 ± 5.4) (Spearman's rank correlation coefficient ρ = 0.81, p < 0.0001). LS values of 135 and 790 were equivalent to CECDAI values of 4.9 and 6.9, respectively. The inflammatory changes by LS were significantly observed in several tertiles in the CECDAI discrepancy group (LS < 135, CECDAI ≥ 4.9) compared with the normal agreement group (LS < 135, CECDAI < 4.9) (p < 0.0001). In both groups, CDAI was also significantly different between Montreal L1 and L3 groups (p = 0.0232, p = 0.0196, respectively). LS inflammation score was 0 in six cases in the LS discrepancy group (LS ≥ 135, CECDAI ≤ 4.9, n = 10); the high LS scores were in patients with high stricture scores. CONCLUSIONS: Discrepancies between the LS and CECDAI scores were observed in some patients. Cases with high CECDAI alone exhibited extensive inflammation and high disease activity (clinical symptoms and biomarker levels). CECDAI seems to better reflect active intestinal inflammation than LS.
BACKGROUND/AIMS: Small bowel capsule endoscopy (SBCE) is used to visualize mucosal inflammatory changes in the small intestine of patients with Crohn's disease (CD). The Lewis score (LS) and Capsule Endoscopy Crohn's Disease Activity Index (CECDAI) are used to evaluate the visualized images. We determined the score disagreement between LS and CECDAI in patients with CD. METHODS: We evaluated 184 SBCE procedures in 102 CDpatients with small bowel lesions. Patients were classified according to the Montreal classification. LS and CECDAI were calculated, and cases with disagreement between the two scores were identified. We investigated the characteristics of disagreement, and analyzed the relationships with the Crohn's Disease Activity Index (CDAI) and C-reactive protein. RESULTS:LS (504 ± 1160) correlated strongly with CECDAI (6 ± 5.4) (Spearman's rank correlation coefficient ρ = 0.81, p < 0.0001). LS values of 135 and 790 were equivalent to CECDAI values of 4.9 and 6.9, respectively. The inflammatory changes by LS were significantly observed in several tertiles in the CECDAI discrepancy group (LS < 135, CECDAI ≥ 4.9) compared with the normal agreement group (LS < 135, CECDAI < 4.9) (p < 0.0001). In both groups, CDAI was also significantly different between Montreal L1 and L3 groups (p = 0.0232, p = 0.0196, respectively). LSinflammation score was 0 in six cases in the LS discrepancy group (LS ≥ 135, CECDAI ≤ 4.9, n = 10); the high LS scores were in patients with high stricture scores. CONCLUSIONS: Discrepancies between the LS and CECDAI scores were observed in some patients. Cases with high CECDAI alone exhibited extensive inflammation and high disease activity (clinical symptoms and biomarker levels). CECDAI seems to better reflect active intestinal inflammation than LS.
Authors: Y Niv; S Ilani; Z Levi; M Hershkowitz; E Niv; Z Fireman; S O'Donnel; C O'Morain; R Eliakim; E Scapa; N Kalantzis; C Kalantzis; P Apostolopoulos; E Gal Journal: Endoscopy Date: 2011-11-28 Impact factor: 10.093
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Authors: I M Gralnek; R Defranchis; E Seidman; J A Leighton; P Legnani; B S Lewis Journal: Aliment Pharmacol Ther Date: 2007-10-23 Impact factor: 8.171
Authors: A Bourreille; A Ignjatovic; L Aabakken; E V Loftus; R Eliakim; M Pennazio; Y Bouhnik; E Seidman; M Keuchel; J G Albert; S Ardizzone; S Bar-Meir; R Bisschops; E J Despott; P F Fortun; R Heuschkel; J Kammermeier; J A Leighton; G J Mantzaris; D Moussata; S Lo; V Paulsen; J Panés; G Radford-Smith; W Reinisch; E Rondonotti; D S Sanders; J M Swoger; H Yamamoto; S Travis; J-F Colombel; A Van Gossum Journal: Endoscopy Date: 2009-07-08 Impact factor: 10.093
Authors: Romain Leenhardt; Anthony Buisson; Arnaud Bourreille; Philippe Marteau; Anastasios Koulaouzidis; Cynthia Li; Martin Keuchel; Emmanuele Rondonotti; Ervin Toth; John N Plevris; Rami Eliakim; Bruno Rosa; Konstantinos Triantafyllou; Luca Elli; Gabriele Wurm Johansson; Simon Panter; Pierre Ellul; Enrique Pérez-Cuadrado Robles; Deirdre McNamara; Hanneke Beaumont; Cristiano Spada; Flaminia Cavallaro; Franck Cholet; Ignacio Fernandez-Urien Sainz; Uri Kopylov; Mark E McAlindon; Artur Németh; Gian Eugenio Tontini; Diana E Yung; Yaron Niv; Gabriel Rahmi; Jean-Christophe Saurin; Xavier Dray Journal: United European Gastroenterol J Date: 2019-12-23 Impact factor: 4.623