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Intestinal alpha 1-antitrypsin clearance was quantified in 17 patients with clinically active Crohn's disease before and after a six-week period of treatment with sulfasalazine and methylprednisolone. Before the study, alpha 1-antitrypsin clearance and, hence, enteric protein loss was elevated as being above control values in 16 patients. After therapy, clearance values decreased in 11 and were normalized in five patients. Serum albumin level was normalized in 11 of 12 patients who had hypoalbuminemia before the study. Clinical condition was improved in all but 1 patient after treatment. There was no close correlation between alpha 1-antitrypsin clearance and disease activity index. These results indicate that antiinflammatory therapy has a beneficial effect on enteric protein loss in Crohn's disease. The measurement of alpha 1-antitrypsin clearance provides a useful adjunctive technique in evaluating intestinal inflammatory activity, and it seems to be of use in following the efficacy of treatment in the course of illness in Crohn's disease.
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