Temporal correlation of the erythrocyte sedimentation rate with tc-99m WBC uptake on children with inflammatory bowel disease

The goal of this study was to evaluate the temporal correlation of Tc-99m WBC studies with the erythrocyte sedimentation rate, a commonly used index of intensity of inflammation, in a large population of children with inflammatory bowel diseases. Over a 6-year period, 313 Tc-99m WBC studies were performed and the hospital charts of these consecutive children were reviewed. In each set of scans (0.5-1 hour and 2-3 hours) from the 313 patients, the bowel was divided into 8 segments resulting in 5008 bowel segments for scoring. The intensity of uptake on the planar images was graded on a scale of 0 to 6 and compared with the erythrocyte sedimentation rate obtained within 3 days, I week, 2 weeks, I month, 3 months, 6 months, or I year of the Tc-99m WBC scan, when available. A dataset of 508 erythrocyte sedimentation rates was available for computation. In children with Crohn's disease, when erythrocyte sedimentation rate is obtained within 3 days of the Tc-99m WBC scan, the correlation coefficient is R = 0.314 (P < 0.005), within I week R = 0.358 (P < 0.05), within 2 weeks R = 0.254 (P = 0.129), within I month R = -0.029 (P = 0.84), within 3 months R = -0.002 (P = 0.989), within 6 months R = 0.241 (P = 0.145). and within I year R = 0.068 (P = 0.759). In children with Crohn's disease, the uptake of Tc-99m WBC correlates well with the erythrocyte sedimentation rate during the flare of inflammation, and the correlation progressively subsides after a few weeks. No such correlation was noted in children with ulcerative colitis.