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2016 ; 9
(ä): 51-62
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The Role of Laboratory Tests in Crohn s Disease
#MMPMID27656094
Cappello M
; Morreale GC
Clin Med Insights Gastroenterol
2016[]; 9
(ä): 51-62
PMID27656094
show ga
In the past, laboratory tests were considered of limited value in Crohn's disease
(CD). In the era of biologics, laboratory tests have become essential to evaluate
the inflammatory burden of the disease (C-reactive protein, fecal calprotectin)
since symptoms-based scores are subjective, to predict the response to
pharmacological options and the risk of relapse, to discriminate CD from
ulcerative colitis, to select candidates to anti-tumor necrosis factors
[screening tests looking for hepatitis B virus and hepatitis C virus status and
latent tuberculosis], to assess the risk of adverse events (testing for
thiopurine metabolites and thiopurine-methyltransferase activity), and to
personalize and optimize therapy (therapeutic drug monitoring). Pharmacogenetics,
though presently confined to the assessment of thiopurineme methyltransferase
polymorphisms and hematological toxicity associated with thiopurine treatment, is
a promising field that will contribute to a better understanding of the molecular
mechanisms of the variability in response to the drugs used in CD with the
attempt to expand personalized care and precision medicine strategies.