Comparison of three tests for faecal calprotectin in children and young adults: a retrospective monocentric study

Abstract

ObjectiveFaecal calprotectin is used as a sensitive marker for gastrointestinal mucosal inflammation. We compared the performance of three different assays in a large cohort of symptomatic paediatric patients.DesignRetrospective monocentric study.SettingInpatients and outpatients of a tertiary referral centre for paediatric gastroenterology.Participants304 symptomatic patients (163 males, aged 2–20 years) with active inflammatory bowel disease (IBD/A, n=130), IBD in clinical remission (IBD/R, n=62), other intestinal diseases (n=45) and controls without identified intestinal disease (n=67).InterventionsCalprotectin was measured in homogenised faecal samples with three tests (A: EliA Calprotectin, Phadia AB, Sweden; B: PhiCal, Calpro AS, Norway; C: EK-Cal, Bühlmann Laboratories, Switzerland).OutcomesConcordance between tests was calculated using Kendall's τ coefficient.ResultsIBD/A and controls were correctly classified as 97.7%/82.1% (A), 97.7%/85.1% (B) and 98.4%/62.7% (C; not significant). Test C tended to have higher calprotectin values with a lower specificity compared to tests A and B. The concordance between two tests was 0.835 for tests A and B, 0.782 for tests A and C and 0.765 for tests B and C.ConclusionsAll three tests are very sensitive for detecting mucosal inflammation, but major differences exist between specificity and absolute values. It is highly advisable to use the test of the same manufacturer for follow-up and to monitor for disease activity.

Laboratory values in Japanese children with newly diagnosed inflammatory bowel disease

“…Recently, fecal calprotectin (FC) has been used as a biomarker for gastrointestinal mucosal inflammation; Prell et al . reported that normal FC concentration indicates absence of IBD in children and young adults . Hoekman et al .…”

“…Recently, fecal calprotectin (FC) has been used as a biomarker for gastrointestinal mucosal inflammation; Prell et al reported that normal FC concentration indicates absence of IBD in children and young adults. 14 Hoekman et al reported that in children with previously diagnosed IBD, clinical disease activity was only weakly associated with inflammatory markers such as FC and CRP. 15 Neither FC nor blood test results such as CRP or ESR are sufficient in themselves for diagnosis of pediatric IBD.…”

Papel de la calprotectina fecal como predictor de enfermedad orgánica: aplicabilidad en la diarrea crónica y la recurrencia endoscópica de la enfermedad de Crohn

“…Hay disponibles pocos estudios en la literatura que realicen comparaciones entre los distintos tipos de test de medición; todos ellos demuestran una gran sensibilidad de los test para la detección de inflamación mucosa, pero se observa una diferencia significativa en la especificidad y su valor absoluto, demostrando variabilidad entre cada tipo de test (27)(28)(29). En la pacientes, encontrando que con un punto de corte de 50 mcg/g, la sensibilidad y especificidad para diferenciar la patología orgánica de la funcional fueron 83% y 84% respectivamente (9).…”

“…Los estudios sobre las diferencias entre los distintos kits que existen en el mercado para la medida de CF, son muy escasos (27)(28)(29)107). En todos ellos se objetivan importantes diferencias entre los diferentes kits.…”

“…La mediana de edad de los pacientes era 55(30) años y el 42% de los pacientes tenía más de 60 años. La proporción por sexos y la edad tanto en uno como otro grupo era la misma; 49% de mujeres en el grupo ELISA y 52% en ELiA, edades de 58(28) años en ELISA y 54(29) años ELiA y 41,5% de pacientes mayores de 60 años en ELISA y 39,5% en ELiA. y 30,4% en ELiA; ni en cuanto a la toma de IBPs: 45,3% en el grupo ELISA y 46,6% en ELiA.…”