الفهرس 
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Abstract
This study was designed to assess apoptosis of peripheral blood lymphocytes in patients with inflammatory bowel disease (IBD) and find out the relation of this parameter with different clinical and laboratory variables in this context.
This study was conducted on 30 children and adolescents diagnosed with inflammatory bowel disease whether CD or UC following up in the pediatric gastroenterology clinic, children hospital, Ain shams University. They were 22 males and 8 females with an age ranging from 3.5 to 16 years and a mean age of 11.1±3.5 years. They were compared with a cohort of 22 healthy infants. Most of the studied patients were reported twice during flare and remission stages; except for 4 patients who were studied during remission only, while 7 patients were studied during flare only.
Patients were subjected to the following:
a) Detailed history taking including gastrointestinal symptoms.
b) Careful clinical examination including, general, abdominal and per rectal examination.
c) Colonoscopy to confirm diagnosis and stage of the disease.
d) For the laboratory workup, clotted venous blood and EDTA blood were collected from all subjects. The total percent of lymphocytes and their absolute counts were quantified using white blood cells obtained from the complete blood picture and flow cytometric analysis. The percent of apoptotic and viable lymphocytes were obtained from their corresponding flow cytometric histograms. Then, their absolute values were calculated against the absolute lymphocytic count.
Our results revealed the following:
* 56.7% of our patients were ulcerative colitis and 43.3% of them were crohn’s disease, 73.3% were males and 26.7% were females with an age ranging from 3.5 to 16 years with a mean of age of 11.1± 3.5 years.
*That there was a lower viable lymphocytic count among cases compared to controls and the difference was highly significant statistically and a higher mean early apoptotic cells (EA) % among cases compared to controls and the difference was highly significant statistically and also a higher mean late apoptotic cells (LA) % among cases compared to controls and the difference was highly significant statistically.
*Higher percentage of right iliac pain among cases with crohn’s disease compared to UC and the difference was highly significant statistically.
*Higher percentage of joint affection among UC patients 93.3% compared to 27.3% among cases of crohn’s disease and the difference was highly significant statistically.
*A higher mean hemoglobin concentration in cases in remission compared to cases in flare and the difference was significant statistically.
*A higher mean TLC in crohn’s disease in flare compared to UC cases in flare and the difference was highly significant statistically.
*A higher mean ESR in CD cases in flare compared to UC cases in flare and the difference was significant statistically.
*A higher mean AST in UC cases in flare compared to CD cases in flare and the difference was significant statistically.
*A higher mean EA cells % among cases of UC in flare 34.9 compared to 20.8 among UC cases in remission and the difference was highly significant statistically.
*A higher mean LA cells % in flare cases of CD compared to cases in remission and the difference was highly significant statistically.
*A higher mean LA cells % among cases with fever compared to cases without fever and the difference was highly significant statistically.
*A higher mean EA cells % among cases with history of joint affection compared to cases with no history of joint affection and the difference was significant statistically.
*A higher mean EA cells % among cases with history of weight loss compared to no history of weight loss and the difference was significant statistically and a higher mean LA cells% among cases with history of weight loss compared to cases with no history of weight loss and the difference was highly significant statistically.
*A higher mean EA cells % among cases with severe inflammation on endoscopic evaluation compared to cases with moderate inflammation and the difference was border line significant.
Thus, we can conclude that there is an increase in circulating lymphocytes apoptosis in both ulcerative colitis and crohn’s disease which is significantly higher in flare compared to remission. Moreover, apoptosis of circulating lymphocytes was more in patients that manifested systemic manifestations. This is an evidence that lymphocyte apoptosis is related to the disease activity. It denotes as well that this consequent disturbed apoptosis is linked in some way to the development of systemic manifestations of IBD patients.