Intestinal fatty acid binding protein (I-FABP) as a marker for acute intestinal ischemia

Abstract

Background: Acute mesenteric ischemia accounts for around 0.1% of all hospital admission and less than 1% of emergency admissions. However, the presentation is varied, and diagnosis is obscure. The diagnosis of intestinal ischemia demands a high index of suspicion. The overall mortality associated with mesenteric ischemia is between 60% and 93% but rises acutely once bowel wall infarction has occurred. Early diagnosis of ischemia remains the key to reduce morbidity and mortality. I-FABP is a cytosolic protein present in epithelial cells of intestines and released upon ischemia or necrosis of bowel. Author estimated the levels of I-FABP in serum and established it as a marker for acute intestinal ischemia.Methods: 40 patients admitted to JSS Hospital with suspected acute intestinal ischemia were included in the study. Plasma concentrations were quantified using ELISA for fatty acid binding protein 2. Statistical methods were applied and sensitivity and specificity of serum I-FABP were determined. Confirmation of ischemia was by histopathological analysis of the resected bowel specimen.Results: 23 patients out of the 40 were diagnosed to have intestinal ischemia. Mean values of serum IFABP levels were significantly higher in patients diagnosed with intestinal ischemia (65.94pg/ml in the non-ischemic group vs 673.53pg/ml in the ischemic group P=0.0002). Cut off chosen in diagnosing intestinal ischemia in this study was 187.59pg/ml. Sensitivity was 95.7% and specificity 88%.Conclusions: Serum I-FABP can be used for the diagnosis for intestinal ischemia. It is specific and sensitive marker to detect early bowel ischemia.