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Erschienen in: Wiener klinische Wochenschrift 7-8/2016

01.04.2016 | original article

Fecal calprotectin as a marker of the severity of mucosal inflammation in children with inflammatory bowel disease

verfasst von: Jernej Dolinšek, Petra Rižnik, Larisa Sabath, Dušanka Mičetić-Turk

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 7-8/2016

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Summary

Objectives

Inflammatory bowel disease (IBD) in children has a remitting and relapsing course. The aim of our study was to evaluate the value of fecal calprotectin (FC), C-reactive protein (CRP), and clinical scores in predicting endoscopic and histological lesions in children with IBD.

Methods

A total of 68 children with IBD (29 with ulcerative colitis (UC), 39 with Crohn’s disease (CD), mean age 14.2 years) were included in the study.
We retrospectively reviewed clinical scores (PUCAI, PCDAI), CRP values, endoscopic, and histological data as well as FC values in all included children.

Results

In children with UC, the correlation between the histological lesions and FC (r = 0.609, p < 0.01), CRP (r = 0.390, n.s.), or PUCAI (r = 0.535, p < 0.05) was higher than for children with CD (FC r =  0.490, n.s.; CRP r =  0.269, n.s.; PCDAI r = 0.257, n.s.). The correlation between endoscopy scores and the same parameters yielded similar findings (UC: FC r = 0.628, p < 0.01; CRP r = 0.387, n.s.; PUCAI r = 0.256, n.s.; CD: FC r = 0.516, p < 0.05; CRP r = 0.238, n.s.; PCDAI r = 0.267, n.s.).
The correlation between FC and PUCAI (r = 0.532, p < 0.01) was higher than that between CRP and PUCAI (r = 0.424, p < 0.01). However, the correlation between FC and PCDAI (0.384, p < 0.01) is lower than that between CRP and PCDAI (r = 0.447, p < 0.01).

Conclusion

FC is a better predictor of the severity of endoscopic and histological lesions than CRP or disease activity scores, especially for UC. FC, as a noninvasive marker, could possibly be used to reduce the number of endoscopic procedures in children with a confirmed diagnosis of IBD.
Literatur
1.
Zurück zum Zitat Konikoff MR, Denson LA. Role of fecal calprotectin as a biomarker of intestinal inflammation in inflammatory bowel disease. Inflamm Bowel Dis. 2006;12:524–34.CrossRefPubMed Konikoff MR, Denson LA. Role of fecal calprotectin as a biomarker of intestinal inflammation in inflammatory bowel disease. Inflamm Bowel Dis. 2006;12:524–34.CrossRefPubMed
2.
Zurück zum Zitat Jelsness-Jørgensen LP, Bernklev T, Moum B. Calprotectin is a useful tool in distinguishing coexisting irritable bowel like symptoms from that of occult inflammation among inflammatory bowel disease patients in remission. Gastroenterol Res Pract. 2013;2013:620707.CrossRefPubMedPubMedCentral Jelsness-Jørgensen LP, Bernklev T, Moum B. Calprotectin is a useful tool in distinguishing coexisting irritable bowel like symptoms from that of occult inflammation among inflammatory bowel disease patients in remission. Gastroenterol Res Pract. 2013;2013:620707.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Aomatsu T, Yodel A, Matsumoto K, et al. Fecal calprotectin is a useful marker for disease activity in pediatric patients with inflammatory bowel disease. Dig Dis Sci. 2011;56:2372–7.CrossRefPubMed Aomatsu T, Yodel A, Matsumoto K, et al. Fecal calprotectin is a useful marker for disease activity in pediatric patients with inflammatory bowel disease. Dig Dis Sci. 2011;56:2372–7.CrossRefPubMed
4.
Zurück zum Zitat García-Sánches V, Iglesias-Flores E, Gonzáles R, et al. Does fecal calprotectin predict relapse in patients with Crohn’s disease and ulcerative colitis. J Crohns Colitis. 2010;4:144–52.CrossRef García-Sánches V, Iglesias-Flores E, Gonzáles R, et al. Does fecal calprotectin predict relapse in patients with Crohn’s disease and ulcerative colitis. J Crohns Colitis. 2010;4:144–52.CrossRef
5.
Zurück zum Zitat Levine A, Koletzko S, Turner D, et al. The ESPHGAN revised porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents. J Pediatr Gastroenterol Nutr. 2014;58:795–806.PubMed Levine A, Koletzko S, Turner D, et al. The ESPHGAN revised porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents. J Pediatr Gastroenterol Nutr. 2014;58:795–806.PubMed
6.
Zurück zum Zitat Komraus M, Wos H, Wiecek S, et al. Usefulness of faecal calprotectin measurement in children with various types of inflammatory bowel disease. Mediators Inflamm. 2012;2012:608249.CrossRefPubMedPubMedCentral Komraus M, Wos H, Wiecek S, et al. Usefulness of faecal calprotectin measurement in children with various types of inflammatory bowel disease. Mediators Inflamm. 2012;2012:608249.CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Ruemmele FM, Veres G, Kolho KL, et al. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease. J Crohns Colitis. 2014;8:1179–207.CrossRefPubMed Ruemmele FM, Veres G, Kolho KL, et al. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease. J Crohns Colitis. 2014;8:1179–207.CrossRefPubMed
8.
Zurück zum Zitat Turner D, Levine A, Escher JC, et al. Management of pediatric ulcerative colitis: joint ECCO and ESPGHAN evidence-based consensus guidelines. J Pediatr Gastroenterol Nutr. 2012;55:340–61.CrossRefPubMed Turner D, Levine A, Escher JC, et al. Management of pediatric ulcerative colitis: joint ECCO and ESPGHAN evidence-based consensus guidelines. J Pediatr Gastroenterol Nutr. 2012;55:340–61.CrossRefPubMed
9.
Zurück zum Zitat Sandhu BK, Fell JM, Beattie RM, et al. Guidelines for the management of inflammatory bowel disease in children in the United Kingdom. J Pediatr Gastroenterol Nutr. 2010;50:S1–13.CrossRefPubMed Sandhu BK, Fell JM, Beattie RM, et al. Guidelines for the management of inflammatory bowel disease in children in the United Kingdom. J Pediatr Gastroenterol Nutr. 2010;50:S1–13.CrossRefPubMed
10.
Zurück zum Zitat Henderson P, Anderson NH, Wilson DC. The diagnostic accuracy of fecal calprotecin during the investigation of suspected pediatric inflammatory bowel disease: a systematic review and meta-analysis. Am J Gastroenterol. 2014;109:637–45.CrossRefPubMed Henderson P, Anderson NH, Wilson DC. The diagnostic accuracy of fecal calprotecin during the investigation of suspected pediatric inflammatory bowel disease: a systematic review and meta-analysis. Am J Gastroenterol. 2014;109:637–45.CrossRefPubMed
11.
Zurück zum Zitat Henderson P, Casey A, Lawrence SJ, et al. The diagnostic accuracy of fecal calprotectin during the investigation of suspected pediatric inflammatory bowel disease. Am J Gastroenterol. 2012;107:941–9.CrossRefPubMed Henderson P, Casey A, Lawrence SJ, et al. The diagnostic accuracy of fecal calprotectin during the investigation of suspected pediatric inflammatory bowel disease. Am J Gastroenterol. 2012;107:941–9.CrossRefPubMed
12.
Zurück zum Zitat Fagerberg Lorentzon U, Lööf L, Lindholm J, et al. Fecal calprotectin: a quantitative marker of colonic inflammation in children with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2007;45:414–20.CrossRef Fagerberg Lorentzon U, Lööf L, Lindholm J, et al. Fecal calprotectin: a quantitative marker of colonic inflammation in children with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2007;45:414–20.CrossRef
13.
Zurück zum Zitat Bunn SK, Bisset WM, Main MJC, et al. Fecal calprotectin as a measure of disease activity in childhood inflammatory bowel disease. J Pediatr Gstroenterol Nutr. 2001;32:171–7.CrossRef Bunn SK, Bisset WM, Main MJC, et al. Fecal calprotectin as a measure of disease activity in childhood inflammatory bowel disease. J Pediatr Gstroenterol Nutr. 2001;32:171–7.CrossRef
14.
Zurück zum Zitat Canani RB, Terrin G, Rapacciuolo L, et al. Faecal calprotectin as reliable non-invasive marker to assess the severity of mucosal inflammation in children with inflammatory bowel disease. Dig Liver Dis. 2008;40:547–53.CrossRefPubMed Canani RB, Terrin G, Rapacciuolo L, et al. Faecal calprotectin as reliable non-invasive marker to assess the severity of mucosal inflammation in children with inflammatory bowel disease. Dig Liver Dis. 2008;40:547–53.CrossRefPubMed
15.
Zurück zum Zitat Hyams JS, Ferry GD, Mandel FS, et al. Developement and validation of a Pediatric Crohn’s Disease Activity Index. J Pediatr Gastroenterol Nutr. 1991;12:439–47.PubMed Hyams JS, Ferry GD, Mandel FS, et al. Developement and validation of a Pediatric Crohn’s Disease Activity Index. J Pediatr Gastroenterol Nutr. 1991;12:439–47.PubMed
16.
Zurück zum Zitat Turner D, Oatley D, Mack D, et al. Developement, validation and evaluation of pediatric ulcerative colitis activity index: a prospective multicentric study. Gastroenterology. 2007;133:423–32.CrossRefPubMed Turner D, Oatley D, Mack D, et al. Developement, validation and evaluation of pediatric ulcerative colitis activity index: a prospective multicentric study. Gastroenterology. 2007;133:423–32.CrossRefPubMed
17.
Zurück zum Zitat Quail MA, Russell RK, Van Limbergen JE, et al. Fecal calprotectin complements routine laboratory investigations in diagnosing childhood inflammatory bowel disease. Inflamm Bowel Dis. 2009;15:756–9.CrossRefPubMed Quail MA, Russell RK, Van Limbergen JE, et al. Fecal calprotectin complements routine laboratory investigations in diagnosing childhood inflammatory bowel disease. Inflamm Bowel Dis. 2009;15:756–9.CrossRefPubMed
18.
Zurück zum Zitat Bremner A, Roked S, Robinson R, et al. Faecal calprotectin in children with chronic gastrointestinal symptoms. Acta Paediatr. 2005;94:1855–8.CrossRefPubMed Bremner A, Roked S, Robinson R, et al. Faecal calprotectin in children with chronic gastrointestinal symptoms. Acta Paediatr. 2005;94:1855–8.CrossRefPubMed
19.
Zurück zum Zitat Gisbert JP, McNicholl AG. Questions and answers on the role of fecal calprotectin as a biological marker of inflammatory bowel disease. Dig Liver Dis. 2009;41:56–66.CrossRefPubMed Gisbert JP, McNicholl AG. Questions and answers on the role of fecal calprotectin as a biological marker of inflammatory bowel disease. Dig Liver Dis. 2009;41:56–66.CrossRefPubMed
20.
Zurück zum Zitat Montalto M, Gallo A, Santoro L, et al. Role of fecal calprotectin in gastrointestinal disorders. Eur Rev Med Pharmacol Sci. 2013;17:1569–82.PubMed Montalto M, Gallo A, Santoro L, et al. Role of fecal calprotectin in gastrointestinal disorders. Eur Rev Med Pharmacol Sci. 2013;17:1569–82.PubMed
21.
Zurück zum Zitat Degraeuwe P, Beld M, Ashorn M, et al. Faecal calprotectin in suspected paediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2015;60:339–46.CrossRefPubMed Degraeuwe P, Beld M, Ashorn M, et al. Faecal calprotectin in suspected paediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2015;60:339–46.CrossRefPubMed
22.
Zurück zum Zitat Sidler MA, Leach ST, Day AS. Fecal S100A12 and fecal calprotectin as noninvasive markers for inflammatory bowel disease in children. Inflamm Bowel Dis. 2008;14:359–66.CrossRefPubMed Sidler MA, Leach ST, Day AS. Fecal S100A12 and fecal calprotectin as noninvasive markers for inflammatory bowel disease in children. Inflamm Bowel Dis. 2008;14:359–66.CrossRefPubMed
23.
Zurück zum Zitat Bunn SK, Bisset WM, Main MJ, et al. Fecal calprotectin: validation as a noninvasive measure of bowel inflammation in childhood inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2001;33:14–22.CrossRefPubMed Bunn SK, Bisset WM, Main MJ, et al. Fecal calprotectin: validation as a noninvasive measure of bowel inflammation in childhood inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2001;33:14–22.CrossRefPubMed
24.
Zurück zum Zitat Diamanti A, Colistro F, Basso MS, et al. Clinical role of calprotectin assay in determining histological relapses in children affected by inflammatory bowel diseases. Inflamm Bowel Dis. 2008;14:1229–35.CrossRefPubMed Diamanti A, Colistro F, Basso MS, et al. Clinical role of calprotectin assay in determining histological relapses in children affected by inflammatory bowel diseases. Inflamm Bowel Dis. 2008;14:1229–35.CrossRefPubMed
25.
Zurück zum Zitat Olafsdottir E, Aksnes L, Fluge G, et al. Faecal calprotectin levels in infants with infantile colic, healthy infants, children with inflammatory bowel disease, children with recurrent abdominal pain and healthy children. Acta Paediatr. 2002;91:45–50.CrossRefPubMed Olafsdottir E, Aksnes L, Fluge G, et al. Faecal calprotectin levels in infants with infantile colic, healthy infants, children with inflammatory bowel disease, children with recurrent abdominal pain and healthy children. Acta Paediatr. 2002;91:45–50.CrossRefPubMed
26.
Zurück zum Zitat Önal I, Beyazit Y, Şener B, Savuk B, Özer Etik D, Sayilir A, et al. The value of fecal carprotectin as a marker of intestinal inflammation in patients with ulcerative colitis. Turk J Gastroenterol. 2012;23(5):509–14.CrossRefPubMed Önal I, Beyazit Y, Şener B, Savuk B, Özer Etik D, Sayilir A, et al. The value of fecal carprotectin as a marker of intestinal inflammation in patients with ulcerative colitis. Turk J Gastroenterol. 2012;23(5):509–14.CrossRefPubMed
27.
Zurück zum Zitat D’Haens G, Ferrante M, Vermeire S, Baert F, Noman M, Moortgat L, et al. Fecal calprotectin is a surrogate marker for endoscopic lesions in inflammatory bowel disease. Inflamm Bowel Dis. 2012;18:2218–24.CrossRefPubMed D’Haens G, Ferrante M, Vermeire S, Baert F, Noman M, Moortgat L, et al. Fecal calprotectin is a surrogate marker for endoscopic lesions in inflammatory bowel disease. Inflamm Bowel Dis. 2012;18:2218–24.CrossRefPubMed
28.
Zurück zum Zitat Kolho KL, Sipponen T, Valtonen E, Savilathi E. Fecal calprotectin, MMP-9, and human beta-defensin-2 levels in pediatric inflammatory bowel disease. Int J Colorectal Dis. 2014;29:43–50.CrossRefPubMed Kolho KL, Sipponen T, Valtonen E, Savilathi E. Fecal calprotectin, MMP-9, and human beta-defensin-2 levels in pediatric inflammatory bowel disease. Int J Colorectal Dis. 2014;29:43–50.CrossRefPubMed
29.
Zurück zum Zitat Berni Canani R, Rapacciuolo L, Romano MT, et al. Diagnostic value of faecal calprotectin in paediatric gastroenterology clinical practice. Dig Liver Dis. 2004;36:467–70.CrossRefPubMed Berni Canani R, Rapacciuolo L, Romano MT, et al. Diagnostic value of faecal calprotectin in paediatric gastroenterology clinical practice. Dig Liver Dis. 2004;36:467–70.CrossRefPubMed
30.
Metadaten
Titel
Fecal calprotectin as a marker of the severity of mucosal inflammation in children with inflammatory bowel disease
verfasst von
Jernej Dolinšek
Petra Rižnik
Larisa Sabath
Dušanka Mičetić-Turk
Publikationsdatum
01.04.2016
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 7-8/2016
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-015-0915-3

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