A laboratory index was developed by Brignola et al to identify patients with asymptomatic Crohn's disease who were at risk for relapse. Patients at risk for relapse might benefit from closer monitoring and earlier interventions. The study was done at the Universita di Bologna in Bologna, Italy.


Laboratory testing:

(1) erythrocyte sedimentation rate (ESR): mm in first hour

(2) acid alpha-1 glycoprotein in mg/dL: reference range 55-140 mg/dL

(3) alpha-2 globulin in g/dL


prognostic index =

= (-3.5) + (0.03 * (ESR)) + (0.013 * (acid alpha-1 glycoprotein in mg/dL)) + (2 * (alpha-2 globulin in g/dL))



• minimum value: close to -2

• maximum value: close to +5

• A value > 0.35 was used to separate patients who relapsed within 18 months from those who did not.


Performance of equation and discriminant value

• sensitivity 71%, specificity 100%

• accuracy 88% and positive predictive value of 100%



• Performance of the index will depend on how well the user's chemical analyses match those of the authors, especially for the acid alpha-1 glycoprotein. The ESR and alpha-2 globulin should be fairly comparable between institutions.


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