IS IT POSSIBLE TO PREDICT THE INFLAMMATORY ACTIVITY OF SMALL BOWEL CROHN'S DISEASE IN CAPSULE ENDOSCOPY USING THE ICCE CRITERIA?

Aims:

A score to predict the indication for small bowel capsule endoscopy (SBCE) in patients with suspected small bowel Crohn's disease (CD) was proposed in 2006 at the International Conference on Capsule Endoscopy (ICCE). The Lewis score and the Capsule Endoscopy Crohn's Disease Activity Index (CECDAI) scores are the most used endoscopic scores to evaluate the inflammatory activity in SBCE. The authors aimed to evaluate the usefulness of the ICCE criteria to predict the severity of small bowel CD in SBCE.

Methods:

Retrospective, single center study, including 49 SBCE of patients with small bowel CD. The ICCE criteria of each patient and LS and CECDAI scores of SBCE were evaluated and compared.

Results:

The mean age was 42.4 years (+13.4). 59.2% of patients were females and 65.3% fulfill the ICCE criteria for SBCE. The median LS and CECDAI scores were 565 and 9.0 (IQR: 2251386 and 6.016.5), respectively. Patients without ICCE criteria had median [IQR] LS of 1012.0 [266.5 – 1354.0] and CECDAI of 12 [8.5 – 17.5] compared to 395.0 [225.0 – 1510.0] (p = 0.4) and 9.0 [4.5 – 15.0] (p = 0.3) in patients with ICCE criteria. No correlation between the sum of items evaluated by the ICCE criteria with the LS (p = 0.5) and CECDAI (p = 0.5) was found. A good correlation between the LS and CECDAI was confirmed (Rho = 0.875, p < 0.001).

Conclusions:

Although the ICCE criteria are useful to select patients with suspected CD to perform SBCE, these criteria are not useful to predict the severity of small bowel inflammatory activity in patients with established CD. Although the LS is more widely used, CECDAI is easier to calculate and has good correlation with LS.