PURPOSE:We have used a novel leukocyte adhesiveness/ aggregation test (LAAT) to show that many patients with inflammatory bowel disease (TOD) in clinical remission have a subclinical low grade inflammation.METHODS:Included in the study are 500 controls, 96 patients with IBD in remission, and 106 patients in relapse.RESULTS:The percent of aggregated white blood cells detected in the peripheral blood was 5.9±3.9, 9.1±5.9, and 18.8±9.4, respectively. The difference between each group and any other was significant atP<0.0001. Similar results were obtained when other acute phase reactants like the erythrocyte sedimentation rate, white blood cell count, differential count, and C‐reactive protein level were examined. However, in a linear regression analysis, LAAT was the only significant(P<0.0006) variable that could classify correctly each subject to the appropriate category of control and IBD in remission or relapse.CONCLUSIONS:Identification of patients with IBD in clinical remission who have ongoing inflammation may be of clinical‐therapeutic relevance. The LAAT is a simple, rapid, and convenient test. The present study indicates that it is also very sensitive.