FZ Elrhaoussi, A Darif*, Z Boukhal, M Tahiri, F Haddad, W Hliwa, A Bellabeh and W Badre

Gastroenterology and Hepatology Department, IBN Rochd University Hospital Center of Casablanca, Morocco

*Corresponding Author: A Darif, Gastroenterology and Hepatology Department, IBN Rochd University Hospital Center of Casablanca, Morocco.

Received: December 16, 2025; Published: December 20, 2025

Abstract

Introduction: Identifying patients with acute severe ulcerative colitis (ASUC) who are refractory to corticosteroids early in the course of treatment is difficult, as no reliable predictive markers are available at admission. This study aims to evaluate whether the CRP/albumin ratio on days 1 and 3 of hospitalization can serve as an early predictor of response to intravenous steroids.

Materials and Methods: We retrospectively collected data from all admissions for ASUC in our center over 5 years. The optimal stool frequency, Lichtiger index, CRP, albumin, and CRP/albumin ratio (CAR) to predict steroid response at Day 1 and 3 was assessed by using the Receiver operating characteristic statistics.

Results: A total of 100 patients with acute severe ulcerative colitis (ASUC) were admitted. Among them, 79 patients responded to corticosteroids, while 10 patients required rescue therapy with infliximab (IFX), and 11 patients underwent colectomy. On day 3, stool frequency and Lichtiger index were significantly higher in the steroid-refractory group (p < 0.001). ROC analysis demonstrated that the day 3 CAR was a more accurate predictor of steroid responsiveness [AUC = 0.884, p < 0.001]. The optimal CAR threshold for predicting steroid response on day 3 was 2.13, with a sensitivity of 81% and a specificity of 83.5%.

Conclusions: Our study showed that a high level of CRP at Day 3 of hospitalization for ASUC and a low albumin level were early predictors of steroid responsiveness. We also showed that the combination of those two markers in a ratio improves their predictive ability.

Keywords: Acute Severe Ulcerative Colitis; Steroids; C-Reactive Protein; Albumin

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Citation

Citation: A Darif.,et al. “Is the C-Reactive Protein/Albumin Ratio a Reliable Marker for Predecting Steroid Response in Acute Severe Ulcerative Colitis?".Acta Scientific Gastrointestinal Disorders 9.1 (2026): 03-08.

Copyright

Copyright: © 2026 A Darif.,et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.