Impact of Fecal Calprotectin Measurement on Decision-making in Children with Inflammatory Bowel Disease

Abstract

BackgroundThe use of fecal calprotectin (FCal) as a marker of intestinal inflammation, in the management of inflammatory bowel disease (IBD) is increasing. The aim of this study was to examine the impact of FCal measurements on decision-making and clinical care of children with IBD.Materials and methodsIn a retrospective cohort study, FCal, clinical activity indices, and blood markers were measured in children with established diagnoses of IBD. Pearson correlation coefficient analysis was performed to examine association between FCal and other markers. Decisions based on FCal measurements were prospectively documented and participants were evaluated 3–6 months later.ResultsA total of 115 fecal samples were collected from 77 children with IBD [median age 14, interquartile range (IQR) 11–15.6 years, 42 females, 37 with Crohn’s disease]. FCal positively correlated with clinical activity indices (r = 0.481, P < 0.05) and erythrocyte sedimentation rate (r = 0.40, P < 0.05) and negatively correlated with hemoglobin (r = −0.40, P < 0.05). Sixty four out of 74 (86%) positive FCal measurements (≥250 μg/g of stools) resulted in treatment escalation with subsequent significant clinical improvement while in the FCal negative group, 34 out of 41 (83%) measurements resulted in no change in treatment and were associated with remission on follow-up.ConclusionBased on high FCal, the majority of children had treatment escalation that resulted in clinical improvement. FCal measurements were useful and reliable in decision-making and clinical care of children with IBD.

Impact of faecal calprotectin measurement on clinical decision-making in patients with Crohn’s disease and ulcerative colitis

“…However, with knowledge of the FC level, physicians would have performed endoscopy in 16 of the 36 patients. Another study showed that 12% of pediatric patients with CD or UC underwent colonoscopy after FC measurement [27]. Our present study is in line with the above, with 12% (28/242) of our adult IBD cohort undergoing a colonoscopy.…”

Increased levels of calprotectin in the saliva of patients with geographic tongue

“…It is clear that GT is an inflammatory condition, given that the level of calprotectin is increased in the saliva of these patients. In other studies, for example, those investigating IBD, the levels of calprotectin were higher when the disease was present, and these levels correlated with the grade of disease (El‐Matary et al, ).…”

“…The level of fecal calprotectin is used in gastroenterology to assess the grade of intestinal inflammation (Tibble et al, ). A positive correlation between increased concentrations of fecal calprotectin and more severe clinical disease has been reported for inflammatory bowel diseases (IBD) (El‐Matary, Abej, Deora, Singh, & Bernstein, ). In infectious and inflammatory conditions, the level of calprotectin is usually increased (Berntzen, Fagerhol, Ostensen, Mowinckel, & Hoyeraal, ; Sander, Fagerhol, Bakken, & Dale, ).…”

Labordiagnostik bei chronisch‑entzündlichen Darmerkrankungen

“…ACCA "anti-chitobioside carbohydrate antibodies", ALCA "anti-laminaribioside carbohydrate antibodies", AMCA "anti-mannobioside carbohydrate antibodies", Anti-C "anti-chitin carbohydrate antibodies", Anti-CBir1 Antikörper gegen das bakterielle Flagellin CBir1, Anti-GP2 Antikörper gegen Glykoprotein 2, Anti-I2 Antikörper gegen die "pseudomonas-associated sequence", Anti-L "anti-laminarin carbohydrate antibodies", Anti-OmpC Antikörper gegen "outer membrane porin C of Escherichia coli", ASCA Antikörper gegen Saccharomyces cerevisiae, CD "Crohn's disease" (M. Crohn), GAB Antikörper gegen "intestinal goblet cells" (Becherzellen des Darms), ND "no data available" (keine Daten erhältlich), PAB "pancreatic antibodies", PPV "positive predictive value" (positiver Vorhersagewert), UC "ulcerative colitis" (Colitis ulcerosa) ASCA "anti-Saccharomyces cerevisiae antibodies", Anti-GP2 Antikörper gegen Glykoprotein 2, CU Colitis ulcerosa, GAB Antikörper gegen Becherzellen des Darms, MC M. Crohn, PAB "pancreatic antibodies", pANCA "perinuclear anti-neutrophil cytoplasmic antibodies", PPV positiver Vorhersagewert, rPAB "recombinant pancreatic antigen" fitäten um 83 % [10]. Ergänzend stellte eine pädiatrische Studie mit fast 80 Kindern fest, dass Therapieintensivierungen -lediglich aufgrund steigender FC-Werte -generell eine klinische Besserung bewirkten und die Messung nur dieses einen Parameters daher wesentlich war [11]. Wie sich ein anderer fäkaler Biomarker, Lactoferrin, im Vergleich zu FC beurteilen lässt, ist einem systematischen Review von 19 Studien mit fast 2500 Patienten mit aktiver CED zu entnehmen: Der Vergleich von CRP, FC, Stuhl-Lactoferrin und dem endoskopischen Befund als "Goldstandard" ergab für das CRP eine Sensitivität von 0,49 bezüglich der endoskopisch aktiven Erkrankung (Spezifität 0,92).…”