Faecal calprotectin levels in infants with infantile colic, healthy infants, children with inflammatory bowel disease, children with recurrent abdominal pain and healthy children

Abstract

Olafsdottir E, Aksnes L, Fluge G, Berstad A. Faecal calprotectin levels in infants with infantile colic, healthy infants, children with in ammatory bowel disease, children with recurrent abdominal pain and healthy children. Acta Paediatr 2002; 91: 45-50. Stockholm. ISSN 0803-5253 This study investigated faecal calprotectin concentration, a measure of intestinal in ammation, in infants and children with abdominal pain. Faecal calprotectin was measured by an enzyme-linked immunosorbent assay kit in spot stool samples in 76 infants with typical infantile colic, 7 infants with transient lactose intolerance and 27 healthy infants. All infants were 2-10 wk of age. In addition, 19 children with recurrent abdominal pain (RAP; mean age 11.5 y), 17 with in ammatory bowel disease (IBD; mean age 11.1 y; 10 had Crohn's disease and 7 ulcerative colitis) and 24 healthy children (mean age 5.3 y) were studied. In infants with infantile colic the mean faecal calprotectin concentration was not different from that in healthy infants (278 § 105 vs 277 § 109 mg kg ¡1 , p = 0.97) or in infants with transient lactose intolerance (300.3 § 124 mg kg ¡ 1 , p = 0.60). The calprotectin level was similar in boys and girls and fell signi cantly with age (p = 0.04). Children with IBD had faecal calprotectin levels (293 § 218 mg kg ¡1 ) much higher than healthy children (40 § 28 mg kg ¡1 , p < 0.0001) and children with RAP without identi ed organic disease (18 § 24 mg kg ¡1 , p < 0.0001).Conclusion: Faecal calprotectin may differentiate between functional abdominal pain and IBD in school-aged children. In young infants high faecal calprotectin levels are normal.

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

“…The patients’ final diagnoses were extracted from the hospital charts. Patients were excluded when there was insufficient clinical information on the final diagnosis or if they were younger than 2 years of age, because particularly infants are known to have high FC levels in the absence of disease 16 17. In patients with proven IBD the disease activity at the time of stool sampling was judged by a paediatric gastroenterologist as clinical remission or active disease based on clinical history and physical examination.…”

Monitoring disease activity by stool analyses: from occult blood to molecular markers of intestinal inflammation and damage

“…As a general rule, markers expressed by phagocytes are more specific for inflammation, while markers also inducible in epithelial cells are more sensitive but can, on the other hand, increase in conditions of non-inflammatory stress, such as lactose intolerance 20. In addition, infants and small children can differ in their expression level of epithelial proteins, which appears at least partially related to feeding formula and the establishment of the normal gut flora 21 – 23…”

Treating infant colic with the probiotic Lactobacillus reuteri: double blind, placebo controlled randomised trial

“…7 One study has suggested that infants with colic may have increased faecal calprotectin levels, 8 suggesting a possible role for gut inflammation; however, another study suggested no differences in faecal calprotectin levels between infants with and infants without colic. 9 No single effective treatment for colic exists, and most clinical guidelines recommend support and reassurance as the mainstay of management. [10][11][12][13] The use of hypoallergenic formulas or elimination of cow's milk protein from the diet of mothers who are breast feeding may possibly be effective, [10][11][12] yet not all irritable infants respond.…”