Fecal Calprotectin in Ileal Crohnʼs Disease

Cerrillo, Elena; Beltrán, Belén; Pous, Salvador; Echarri, Ana; Gallego, José C.; Iborra, Marisa; Pamies, J.; Nos, Pilar

doi:10.1097/mib.0000000000000404

Cited by 53 publications

(24 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, Elena et al . reported that FC levels were significantly correlated with the degree of MRE inflammatory activity (Spearman’s r = 0.56, P < 0.001) 26 . One possible explanation for the discrepancy is that a relatively small number of patients was eligible in the subgroup analysis (n = 29).…”

Section: Discussionmentioning

confidence: 98%

Levels of Faecal Calprotectin and Magnetic Resonance Enterocolonography Correlate with Severity of Small Bowel Crohn’s Disease: A Retrospective Cohort Study

Cheng

Chen

et al. 2017

Sci Rep

View full text Add to dashboard Cite

Few studies have evaluated the usefulness of fecal calprotectin (FC) or magnetic resonance enterography (MRE) in diagnosing active Crohn’s disease (CD) of the small bowel. In the study, we investigated the reliability of FC and MRE in assessing the activity of ileal CD and further explored the relationship between levels of FC and MRE scores. A total of 221 patients were diagnosed with ileal or ileo-colitis CD in our department between July 2012 and October 2016. The global magnetic resonance index of activity (MaRIA) correlated with the simple endoscopic score for CD (SES-CD) (r = 0.527, P = 0.005). When analysed segment-by-segment, a significant correlation was still observed (r = 0.590, P < 0.001). The SES-CD correlated closest with FC (r = 0.503), followed by CRP (r = 0.461), ESR (0.377) and the CDAI (r = 0.320). In receiver operating characteristic (ROC) analyses, the FC cut-off value of mucosal healing was 213.1 μg/g, with 76.1% sensitivity and 66.7% specificity. As for MaRIA, a cut-off value of 6.8 for each segment provided a sensitivity of 100% and a specificity of 79.2%. No agreement between MaRIA and FC levels was found. In conclusion, a combination of FC levels and MaRIA could be effective in monitoring mucosal activity in patients with small bowel CD.

show abstract

Section: Discussionmentioning

confidence: 98%

Levels of Faecal Calprotectin and Magnetic Resonance Enterocolonography Correlate with Severity of Small Bowel Crohn’s Disease: A Retrospective Cohort Study

Cheng

Chen

et al. 2017

Sci Rep

View full text Add to dashboard Cite

show abstract

“…FC is a biomarker that reflects intestinal mucosal damage, and using a cut-off point of 250 μg/g, as in our study, the sensitivity and specificity of detecting active inflammation in IBD are about 80%, when compared with endoscopy[15-17]. However, some other studies have shown that FC presents a better sensitivity than specificity, which could explain the false-positive results[4,18-20]. Furthermore, the best area under the curve was demonstrated in studies that correlated low FC levels with inactive disease[21,22].…”

Section: Discussionsupporting

confidence: 49%

Inter- and intraobserver agreement in computed tomography enterography in inflammatory bowel disease

Horvat

Tavares

Andrade

et al. 2016

WJG

View full text Add to dashboard Cite

AIMTo evaluate intra- and interobserver agreement in imaging features in inflammatory bowel disease and comparison with fecal calprotectin (FC) levels.METHODSOur institutional computed tomography enterography (CTE) database was retrospectively queried to identify patients who underwent CTE from January 2014 to June 2015. Patient inclusion criteria were confirmed inflammatory bowel disease (IBD) and FC collected < 4 mo after CTE without any change in clinical treatment or surgical treatment during this interval. The exclusion criterion was poor image quality. Two blinded abdominal radiologists, with 12 and 3 years of experience analyzed the CTE regarding localization (small bowel, colonic, both, or no disease detected); type of IBD (inflammatory, stenosing, fistulizing, > 1 pattern, or normal); and signs of active disease (present or absent). In 42 of 44 patients evaluated, routine CTE reports were made by one of the readers who re-evaluated the CTEs ≥ 6 mo later, to determine the intraobserver agreement. FC was considered a sign of disease activity when it was higher than 250 μg/g.RESULTSForty-four patients with IBD (38 with Crohn’s disease and 6 with ulcerative colitis) were included. There was a moderate interobserver agreement regarding localization of IBD (κ = 0.540), type of disease (κ = 0.410) and the presence of active signs in CTE (κ = 0.419). There was almost perfect intraobserver agreement regarding localization, type and signs of active disease in IBD. The κ values were 0.902, 0.937 and 0.830, respectively. After a consensus between both radiologists regarding inflammatory activity in CTE, we found that 24 (85.7%) of 28 patients who were classified with active disease had elevated FC, and six (37.5%) of 16 patients without inflammatory activity in CTE had elevated FC (P = 0.003). The correlation between elevated FC and the presence of active disease in CTE was significant (κ = 0.495, P = 0.001).CONCLUSIONWe found almost perfect intraobserver and moderate interobserver agreement in the signs of active disease in CTE with concurrence of high FC levels.

show abstract

“… 10 – 16 At entry, total colonoscopy was undertaken in all patients to detect large bowel inflammation. In the previous studies, 24 – 32 the methods of investigating large bowel inflammation and the timing of investigation were not recorded in detail. It is therefore unclear whether there was no large bowel inflammation at the time of collecting a stool sample.…”

Section: Discussionmentioning

confidence: 99%

“…Most previous studies investigated the value of faecal calprotectin alone. 24 – 27 , 30 – 33 To our knowledge, this is the first study to assess the value of the three major faecal biomarkers simultaneously using the same stool sample. Further, previous studies 24 – 29 , 31 included patients with suspected (unestablished) CD.…”

Section: Discussionmentioning

confidence: 99%

“…Capsule endoscopy has been commonly used in several studies. 24 – 31 Magnetic resonance enterography (MRE) 32 and balloon-assisted enteroscopy 33 are alternative techniques. We used CTE as a cross-sectional imaging technique for the assessment of small bowel inflammation because it is the most common and widely available diagnostic technology in our institute.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Faecal biomarkers for screening small bowel inflammation in patients with Crohn’s disease: a prospective study

Shimoyama

Yamamoto

Umegae

et al. 2017

Therap Adv Gastroenterol

View full text Add to dashboard Cite

Background:The value of faecal biomarkers for screening small bowel inflammation in patients with Crohn’s disease (CD) remains to be elucidated. This prospective study was to evaluate the utility of faecal biomarkers for detecting small intestinal inflammation.Methods:A total of 122 consecutive patients with a diagnosis of CD in the small intestine were screened for eligibility. Computed tomography enterography (CTE) was undertaken to evaluate small bowel inflammation followed by colonoscopy to confirm no large bowel involvement. Seventy eligible patients with inflammation confined to the small intestine were included. Faecal samples were collected for assaying calprotectin, lactoferrin and haemoglobin. For assessing the degree of small bowel inflammation, a semi-quantitative scoring system (CTE0, normal; CTE1, mild; CTE2, moderate; CTE3, severe) was applied.Results:The median calprotectin, lactoferrin and haemoglobin levels were significantly higher in patients with small bowel inflammation, CTE scores 1–3 (n = 42) versus 0 (n = 28): calprotectin, 330 versus 40 ng/ml, p < 0.0001; lactoferrin, 14 versus 3 ng/ml, p < 0.0001; haemoglobin, 29.5 versus 6.5 ng/ml, p = 0.005. There was a strong positive relationship between the faecal biomarkers and CTE score: calprotectin, p < 0.0001; lactoferrin, p < 0.0001; haemoglobin, p = 0.0004. A cutoff value of 140 ng/ml for calprotectin had a sensitivity of 69% and a specificity of 82% with an area under the receiver operating characteristic curve (AUC) of 0.82 to detect small bowel inflammation (CTE scores 1–3), while lactoferrin 6 ng/ml had a sensitivity of 69% and a specificity of 79% with an AUC of 0.83, and haemoglobin 9 ng/ml showed a sensitivity of 71% and a specificity of 39% with an AUC of 0.70.Conclusions:Faecal calprotectin, lactoferrin, and to a lesser degree haemoglobin are relevant biomarkers for screening small bowel inflammation in CD patients without large bowel involvement. Further well-designed large-scale studies in this clinical setting should strengthen our findings.

show abstract

Fecal Calprotectin in Ileal Crohnʼs Disease

Abstract: FC correlates with the degree of MRE inflammatory activity and with surgical pathology damage in ileal CD. Thus, FC could be a surrogate marker of disease control used to select patients for MRE assessment and therapeutic adjustment.

Cited by 53 publications

References 27 publications

Levels of Faecal Calprotectin and Magnetic Resonance Enterocolonography Correlate with Severity of Small Bowel Crohn’s Disease: A Retrospective Cohort Study

Levels of Faecal Calprotectin and Magnetic Resonance Enterocolonography Correlate with Severity of Small Bowel Crohn’s Disease: A Retrospective Cohort Study

Inter- and intraobserver agreement in computed tomography enterography in inflammatory bowel disease

Faecal biomarkers for screening small bowel inflammation in patients with Crohn’s disease: a prospective study

Contact Info

Product

Resources

About