Measurement of Fecal Calprotectin Improves Monitoring and Detection of Recurrence of Crohn's Disease After Surgery

Abstract

and PV Desmond have no conflicts of interest to declare. P De Cruz has received travel grant support from Abbott and Schering-Plough. MA Kamm has acted as an advisor to Abbott and Janssen, has received research support from Abbott, and has acted as a speaker at symposiums sponsored by Abbott and Janssen. A Hamilton has received an educational grant from Abbott. D Liew has served on advisory boards and received research grants from Abbott. IC Lawrance has been on an advisory board for Abbott and Janssen, a speaker for Abbott and Janssen, and has held research and travel grants from Abbott and Janssen. JM Andrews has been an advisory board member for both Janssen and Abbott, spoken for both Abbott and Janssen, received research funds from both Abbott and Janssen, and received travel grants from both Abbott and Janssen. PA Bampton has been on advisory boards for Janssen and Abbott, has received research funding from Abbott, and travel sponsorship from both Abbott and Janssen. PR Gibson has received consulting fees from Abbott, Janssen, and Schering-Plough; research support from Abbott; and payments for lectures from Abbott and Janssen. FA Macrae has been on an advisory board to Janssen, has received travel grants from Abbott, and has received clinical research support from Janssen, Abbott and MSD. W Selby has been on an advisory board for Abbott. SJ Bell has received travel assistance from Abbott. SJ Brown has received travel support and speaker fees from both Abbott and Janssen. WR Connell has been on advisory board for Janssen and a speaker for Abbott and Janssen. AS Day has been an M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT advisor to Janssen. RB Gearry has been on an advisory board for Abbott and Janssen, a speaker for Abbott and Janssen, and held research, educational and travel grants from Abbott and Janssen.

Fecal calprotectin in the prediction of postoperative recurrence of Crohn's disease in children and adolescents

“…FC was a relatively accurate predictor of both endoscopic and histological disease recurrence with AUROC values of 0.71 and 0.78. Even though this is a retrospective study based on a small sample, our results strongly suggest postoperative FC behaves in children and adolescents similarly as previously demonstrated among adult CD patients [8,25]. Fasting, bowel preparation, and requirement of anesthesia make endoscopies particularly demanding for children.…”

“…Ileum is affected in 70% of children and is prone to stricture and fistula formation, which occur in about 25% of pediatric CD patients [3,4,6]. Resection of the affected bowel segment either because of such complications or for unresponsive luminal disease is performed in 30-50% of pediatric CD patients by young adulthood [4,7] and as many as 70% of operated patients require further surgery during their lifetime [8,9].…”

“…Recurrent mucosal inflammation is observed in endoscopy in 70-90% of adult CD patients within a year of surgery although only one third present with symptomatic relapse of the disease [1,[8][9][10]. Histological activity may develop at the site of the anastomosis as soon as after a week of bowel resection [11].…”

“…Even though longer postoperative remission periods are reported for children, most studies have monitored clinical recurrence rates instead of endoscopic follow-up [2,[12][13][14][15]. As clinical symptoms are frequently absent and serum biochemical markers normal until significant inflammatory changes have developed, ileocolonoscopy with histological verification should be considered as the gold standard for assessing disease activity and postoperative recurrence [6,[8][9][10]16].…”

“…Its concentration has been shown to increase in the presence of histological pouch inflammation following proctocolectomy for ulcerative colitis [24]. In addition, FC levels correlate with endoscopic disease recurrence rates after bowel resection in adult CD patients [8,25], although not all studies have confirmed this association [26,27]. In pediatric Crohn patients, FC has not been evaluated postoperatively and neither has its correlation with histological recurrence been assessed after surgery.…”