How is disease activity in adults with Crohn disease assessed?

Updated: Jul 26, 2019
  • Author: Leyla J Ghazi, MD; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Answer

Multiple scoring systems incorporating the patient’s history, physical examination findings, and laboratory data have been developed to assess disease activity in adults with Crohn disease. These scoring systems are used principally for assessing the efficacy of treatment and evaluating new therapies for research purposes.

One such index is the Crohn Disease Activity Index (CDAI), which was developed for use in adults. The Pediatric Crohn Disease Activity Index (PCDAI) was developed and validated in 1990; the results are correlated with the physician’s global assessment and with the Harvey-Bradshaw index (HBI), and they have significant interobserver reliability. The important difference between the PCDAI and the CDAI is the inclusion of growth parameters in the PCDAI score.

A modified PCDAI (Mod PCDAI), consisting of the laboratory measures of the PCDAI plus the C-reactive protein (CRP) level, has been shown to correlate with the PCDAI, the physician’s assessment, and fecal calprotectin. [55] This modified index can be used as an alternative to the PCDAI, with the advantage of having additional objective laboratory values embedded in it. [55] Other authors have described a short PCDAI. [56]


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