Su1188 Transabdominal Ultrasound Has High Negative Predictive Value for Short-Term Complications of Inflammatory Bowel Disease

Abstract Background and study aims Chromoendoscopy with targeted biopsy is the technique of choice for colorectal cancer screening in longstanding inflammatory bowel disease. We aimed to analyze results of a chromoendoscopy screening program and to assess the possibility of identifying low-risk dysplastic lesions by their endoscopic appearance in order to avoid histological analysis. Materials and methods We retrospectively reviewed chromoendoscopies performed between February 2011 and June 2017 in seven Spanish hospitals in a standardized fashion. We analyzed the findings and the diagnostic yield of the Kudo pit pattern for predicting dysplasia. Results A total of 709 chromoendoscopies (569 patients) were reviewed. Median duration of disease was 16.7 years (SD 8.1); 80.4 % had ulcerative colitis. A total of 2025 lesions (3.56 lesions per patient) were found; two hundred and thirty-two lesions were neoplastic (11.5 %) (223 were LGD (96.1 %), eight were HGD (3.4 %), and one was colorectal cancer (0.5 %). The correlation between dysplasia and Kudo pit patterns predictors of dysplasia (≥ III) was low, with an area under the curve of 0.649. Kudo I and II lesions were correctly identified with a high negative predictive value (92 %), even by non-experts. Endoscopic activity, Paris 0-Is classification, and right colon localization were risk factors for dysplasia detection, while rectum or sigmoid localization were protective against dysplasia. Conclusions Chromoendoscopy in the real-life setting detected 11 % of dysplastic lesions with a low correlation with Kudo pit pattern. A high negative predictive value would prevent Kudo I and, probably, Kudo II biopsies in the left colon, reducing procedure time and avoiding complications.

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Biomarkers and Hematological Indices in the Diagnosis of Iron Deficiency in Children with Inflammatory Bowel Disease

Nutrients ◽

10.3390/nu12051358 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1358 ◽

Cited By ~ 1

Author(s):

Paulina Krawiec ◽

Elżbieta Pac-Kożuchowska

Keyword(s):

Inflammatory Bowel Disease ◽

Iron Deficiency ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Bowel Disease ◽

Predictive Value ◽

Iron Homeostasis ◽

Added Value ◽

Predictive Values ◽

Inflammatory Bowel

Inflammation may affect many routinely available parameters of iron homeostasis. Thus, the recognition of iron deficiency in inflammatory bowel disease (IBD) remains a diagnostic challenge in a clinical routine. The aim of the study was to detect the most efficient marker of iron deficiency in IBD children. In a group of 75 IBD children, we evaluated the sensitivity, specificity, accuracy, and positive and negative predictive values of erythrocytes’ indices, including MCV, MCH, MCHC and RDW, and biochemical markers, including iron, transferrin, sTfR and sTfR/log ferritin, for identifying iron deficiency. Receiver operating characteristic (ROC) analysis was used to compare the ability of these parameters to detect iron deficiency. The best predictors of iron deficiency were sTfR/log ferritin, with accuracy 0.86, sensitivity 0.98, specificity 0.63, positive predictive value 0.83 and negative predictive value 0.94, and sTfR, with accuracy 0.77, sensitivity 0.82, specificity 0.67, positive predictive value 0.82 and negative predictive value 0.67. Moreover, sTfR/log ferritin exhibited the largest area under ROC (0.922), followed by sTfR (0.755) and MCH (0.720). The sTfR/log ferritin index appears to be the most efficient marker of iron depletion in pediatric IBD, and it may give an added value in the management of IBD patients.

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Preoperative biological therapy and short-term outcomes of abdominal surgery in patients with inflammatory bowel disease

Gut ◽

10.1136/gutjnl-2011-301495 ◽

2012 ◽

Vol 62 (3) ◽

pp. 387-394 ◽

Cited By ~ 82

Author(s):

Matti Waterman ◽

Wei Xu ◽

Amreen Dinani ◽

A Hillary Steinhart ◽

Kenneth Croitoru ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Abdominal Surgery ◽

Bowel Disease ◽

Biological Therapy ◽

Short Term ◽

Inflammatory Bowel

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Fecal calprotectin is an early predictor of endoscopic response and histologic remission after the start of vedolizumab in inflammatory bowel disease

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284820979765 ◽

2020 ◽

Vol 13 ◽

pp. 175628482097976

Author(s):

Renske W. M. Pauwels ◽

Christien J. van der Woude ◽

Nicole S. Erler ◽

Annemarie C. de Vries

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Predictive Value ◽

Fecal Calprotectin ◽

Clinical Decisions ◽

Inclusion Criteria ◽

Inflammatory Bowel ◽

A Prospective Study ◽

Colonic Biopsies ◽

Study Inclusion

Background and aims: Early prediction of the effect of vedolizumab (VDZ) in inflammatory bowel disease (IBD) is of paramount importance to guide clinical decisions. This study assessed whether early fecal calprotectin (FC) can predict endoscopic response and histologic remission after VDZ initiation. Methods: This was a prospective study. Inclusion criteria were endoscopic inflammation and FC >100 µg/g. FC was determined at baseline and weeks 2, 4, 8 and 16. At week 16, endoscopies with ileal and colonic biopsies were performed. FC changes were assessed with Wilcoxon Rank Sum tests. ROC statistics were used to assess the diagnostic accuracy of FC. Results: In total, 45 patients [27 Crohn’s disease (CD), 16/2 ulcerative colitis (UC)/IBD-unclassified] [40% males, median age 39 (28–51) years] were included. Week 16 endoscopic response and histologic remission rates were 58% and 33%. A median 37% decline in FC at week 2 was observed only in endoscopic responders, p = 0.025. FC <250 µg/g at week 8 predicted endoscopic response in both UC and CD (positive predictive value 100%), whereas absence of FC decline at week 8 corresponded with absence of endoscopic response in CD [negative predictive value (NPV) 82%] and absence of histologic remission in both UC and CD (NPV 90%). Conclusion: The onset of a decline in FC as early as week 2 is associated with endoscopic response to VDZ induction. FC <250 µg/g at week 8 is associated with endoscopic response, whereas absence of FC decline at week 8 is associated with absence of both endoscopic response and histologic remission. FC levels 8 weeks after the start of VDZ could be used to guide clinical decisions and might substitute for endoscopic response evaluation.

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P311. No difference in immunogenicity of the original and biosimilar infliximab in patients with inflammatory bowel disease: short-term results

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjw019.430 ◽

2016 ◽

Vol 10 (suppl 1) ◽

pp. S251.1-S251

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Short Term ◽

Inflammatory Bowel

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Fecal Calprotectin in Combination With Standard Blood Tests in the Diagnosis of Inflammatory Bowel Disease in Children

Frontiers in Pediatrics ◽

10.3389/fped.2020.609279 ◽

2021 ◽

Vol 8 ◽

Author(s):

Shaun S. C. Ho ◽

Michael Ross ◽

Jacqueline I. Keenan ◽

Andrew S. Day

Keyword(s):

Inflammatory Bowel Disease ◽

Platelet Count ◽

Bowel Disease ◽

Predictive Value ◽

Screening Test ◽

Fecal Calprotectin ◽

Non Invasive ◽

Blood Tests ◽

Inflammatory Bowel ◽

Sensitivity Specificity

Introduction: Fecal calprotectin (FC) is a useful non-invasive screening test but elevated levels are not specific to inflammatory bowel disease (IBD). The study aimed to evaluate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FC alone or FC in combination with other standard blood tests in the diagnosis of IBD.Methods: Children aged <17 years who had FC (normal range <50 μg/g) measured and underwent endoscopy over 33 months in Christchurch, New Zealand were identified retrospectively (consecutive sampling). Medical records were reviewed for patient final diagnoses.Results: One hundred and two children were included; mean age was 12.3 years and 53 were male. Fifty-eight (57%) of the 102 children were diagnosed with IBD: 49 with Crohn's disease, eight with ulcerative colitis and one with IBD-unclassified. FC of 50 μg/g threshold provided a sensitivity of 96.6% [95% confident interval (CI) 88.3–99.4%] and PPV of 72.7% (95% CI 61.9–81.4%) in diagnosing IBD. Two children with IBD however were found to have FC <50 μg/g. Sensitivity in diagnosing IBD was further improved to 98.3% (95% CI 90.7–99.1%) when including FC >50 μg/g or elevated platelet count. Furthermore, PPVs in diagnosing IBD improved when FC at various thresholds was combined with either low albumin or high platelet count.Conclusion: Although FC alone is a useful screening test for IBD, a normal FC alone does not exclude IBD. Extending FC to include albumin or platelet count may improve sensitivity, specificity, PPV and NPV in diagnosing IBD. However, prospective studies are required to validate this conclusion.

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