Background: The inflammatory process in the colonic mucosa among ulcerative colitis (UC) patients could be reflected as systemic inflammatory response with subsequent elevation of the various inflammatory biomarkers. We aimed at this research to evaluate the role of systemic inflammatory mediators; erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum albumin level, total leucocytic count, leucocyte/platelet ratio and mean platelet volume (MPV) as predictors of the severity of mucosal inflammation in patient with ulcerative colitis.

Methods: Our cross-sectional study included 30 cases diagnosed with ulcerative colitis in different stages of the disease. Estimation of serum ESR, CRP, TLC levels were done for all participants.

Results: After applying regression analysis, both WBCs count, and fecal calprotectin were significant predictors of disease activity. CRP and WBC/ platelet ratio were significantly correlated to Mayo score of the patients (p= 0.001, 0.007 respectively). Sensitivity of CRP (>15) ESR (>19.5), WBCs count (>8500), WBCs/ platelet ratio (>0.029), , MPV (>8.75 f/L) serum albumin level (>4.15 gm) as a predictors of disease activity were 90.8%, 81.8%,90.9%, 72.7%, 54.5% and 63.6%, respectively with the ability to exclude 81.3%, 73.5%,85.2%,78.9%, 53.1%and 57.3%, of negative cases respectively and accuracy of 86.7%,76.7%,, 86.7%, 76.7%,53.3%,60.0%, respectively.

Conclusions: The levels of CRP, white blood cell count, leukocyte/platelet ratio, and fecal calprotectin were significantly greater in individuals with active UC compared to those in remission. CRP, WBCs count, leukocyte/platelet ratio and fecal calprotectin may be utilized as useful indexes to assess the activity and severity of UC.