Successful detection and removal of predictable juvenile polyp: a case report

Abstract

Juvenile polyp makes up 70% to 80% of pediatric colon polyp, and the average age of diagnosis is 2 to 5 years. The treatment of juvenile polyp in children is polypectomy through colonoscopy. The fact that the lumen of intestine is much smaller than that of adults and the need to perform polypectomy is a heavy burden on the endoscopists. Recently, fecal calprotectin (FC) has been found to be related to juvenile polyp. A previously healthy, 34-month-old female presented to the pediatric department of gastroenterology with intermittent bloody stools which were getting worse. FC level was abnormally elevated at 2,719 µg/g (normal, < 50 µg/g). The polyp was successfully removed with a polypectomy. This is the first case in Korea to show that FC can be used to screen juvenile polyp in children. FC levels can increase with the degree of inflammation regardless of the number or size of the polyp.

Fecal Calprotectin Levels Significantly Correlate with Polyp Size in Children and Adolescents with Juvenile Colorectal Polyps

“…Based on its biochemical stability at room temperature and the consistency of test results, it is widely used as a screening and monitoring tool for disease activity in various clinical fields, including inflammatory bowel disease [ 2 9 10 ]. Several previous reports have suggested an increasing tendency to utilize FC in JPs [ 3 6 7 8 ]. However, the underlying mechanism is yet to be elucidated and there is no clear consensus on its usefulness [ 2 ].…”

“…Tissue neutrophilia is a characteristic of JPs, and degradation and exfoliation of neutrophils into stool may lead to elevated fecal calprotectin (FC) levels [ 6 ]. Recent reports and studies have shown that FC levels are elevated in JPs and are normal post-polypectomy [ 3 6 7 ]. Although JPs are associated with increased FC, normal FC levels do not exclude JPs’ presence [ 2 ].…”