Clinical, Laboratory, Endoscopical and Histological Characteristics Predict Severe Ulcerative Colitis.

BACKGROUND/AIMS: Ulcerative colitis is a remitting and relapsing chronic inflammatory disorder of the colon with a mortality rate of 7% from acute severe UC. METHODOLOGY: A retrospective study of the correlation of clinical indicators, laboratory indicators, endoscopical features, and histological features with clinical severity of UC was conducted in 125 UC cases. RESULTS: Diarrhea, mucous and pus in the stool, fever, anemia, weight loss and tachycardia symptoms and the erythrocyte sedimentation rate, concentrations of C-reactive protein, amount of white blood cells and platelets, and positive occult blood test positively correlated with the severity of disease. Whereas, serum total protein, albumin, and hemoglobin levels negatively correlated with the severity of UC. The endoscopic observations of mucosa bleeding, granular mucosa, pseudopolyps, pouch lighter or disappeared, and luminal stenosis as well as the grade and extent of disease were significantly associated with the severity of UC. Histological grade and granular mucosa were significantly associated with the severity of UC. Failure of conservative treatment, severely low gastrointestinal bleeding, and the discovery of a suspicious cancer in the biopsy are the main indicators for colectomy. CONCLUSIONS: Significant reduction in serum total protein, albumin, and hemoglobin concentration is a relatively specific indicator of severe UC.