Poster (15W147)

Introducing a novel disease activity index for mesenteric manifestations in Crohn’s disease

Author(s)

M.G. Kiernan1, S.M. Sahebally1,2, A. Jarrar3, J.P. Burke4,5, J. Hogan2, P.A. Kiely6, B. Shen3,7, M. Moloney8, M. Skelly8, D. Leddin9, H. Hedayat2, P.N. Faul10, V. Healy10, P.R. O’ Connell4,5, S. Martin5, F Shanahan, C Dunne1, JC Coffey1,2.

Department(s)/Institutions

1Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation and Immunity (4i), University of Limerick, 2Department of Surgery, University Hospital Limerick, 3The Lerner College of Medicine, Cleveland Clinic Foundation, 4School of Medicine and Medical Sciences, UCD, 5Centre for Colorectal Disease, St. Vincent’s University Hospital, Dublin,

Introduction

The mesentery contributes to inflammation in Crohn’s disease(1). Mesenteric fat wrapping and thickening are unique to Crohns disease but as yet no studies have quantitated mesenteric disease.

Aims/Background

This study aimed to develop a novel disease activity index for mesenteric disease in Crohn’s patients. A second aim was to investigate the relationship between mesenteric disease and other manifestations of Crohn’s disease.

Method

Ethical approval and informed consent were obtained from the HSE Mid-Western Regional Hospital Research Ethics Committee. Both mesenteric and mucosal disease were graded based on presence and extent of the factors listed in Table 1. The relationships between mesenteric, mucosal and systemic disease activity indices (i.e. the Crohn’s disease activity index (CDAI)) were determined. The effect of smoking on each activity index was evaluated. Data are presented as mean ± standard deviation (SD). Statistical analyses were performed in SPSSv22.

Results

Mesenteric disease activity index directly correlated with the mucosal disease activity index (r=0.76; p<0.001). A direct correlation occurred between the mesenteric disease activity score and CDAI (r=0.71; p<0.01). The mesenteric disease score was significantly worse in patients who smoked (4.1 ± 1.66 vs. 2.7 ± 1.50, p<0.05). Neither the mucosal disease activity index, nor CDAI, significantly worsened in smokers (9.2 ± 4.18 vs. 7.8 ± 4.87, p=0.499, for mucosal disease activity index) and (318 ± 110.4 vs. 304 ± 73.5, p=0.722, for CDAI).

Conclusions

A novel mesenteric disease activity index was developed. This correlated with a similar mucosal disease activity index, as well as with the Crohn’s disease activity index. Only the mesenteric disease activity index worsened significantly in patients who smoked. Table 1: Scoring system for (i) mesenteric disease manifestations and (ii) mucosal disease manifestations.