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Elevated production and excretion of neopterin indicate activation of cell-mediated immunity, since neopterin is produced in large quantities by human macrophages after stimulation with interferon gamma. In 21 patients, aged 9 to 19 years, with Crohn’s disease, urinary neopterin was measured on a total of 135 consecutive followup visits. Additionally, a large panel of anamnestic, clinical and laboratory data were obtained at every visit. Both the first visit data set (21 records) and the complete data set (135 records) were analyzed separately. As was previously demonstrated in adults with Crohn’s disease, neopterin excretion proved to be strongly correlated with overall rating of disease activity, and also with separate anamnestic, clinical and laboratory activity scores. Multiple regression analysis demonstrated that neopterin provides statistically independent information. Thus, measurement of neopterin concentrations as a marker for activation of cellular immune phenomena could aid in the monitoring of pediatric and juvenile Crohn’s disease.

Urinary Neopterin as Marker for Disease Activity in Children and Adolescents with Crohn’s Disease