Su1216 Low Fecal Calprotectin Correlates With Histological Remission and Mucosal Healing in Ulcerative Colitis and Colonic Crohn's Disease

Background Determination of fecal calprotectin can provide an important guidance for the physician, also in primary care, in the differential diagnosis of gastrointestinal disorders, meanly between inflammatory bowel diseases and irritable bowel syndrome. Objectives The aims of the present study were to prospectively investigate, in Brazilian adults with gastrointestinal complaints, the value of fecal calprotectin as a biomarker for the differential diagnosis between functional and organic disorders and to correlate the concentrations with the activity of inflammatory bowel diseases. Methods The study included consecutive patients who had gastrointestinal complaints in which the measurement levels of fecal calprotectin were recommended. Fecal calprotectin was measured using a Bühlmann (Basel, Switzerland) ELISA kit Results A total of 279 patients were included in the study, with median age of 39 years (range, 18 to 78 years). After clinical and laboratorial evaluation and considering the final diagnosis, patients were allocated into the following groups: a) Irritable Bowel Syndrome: 154 patients (102 female and 52 male subjects). b) Inflammatory Bowel Diseases group: 112 patients; 73 with Crohn’s disease; 38 female and 35 male patients; 52.1% (38/73) presented active disease, and 47.9% (35/73) had disease in remission and 39 patients with ulcerative colitis;19 female and 20 male patients; 48.7% (19/39) classified with active disease and 49.3% (20/39) with disease in remission. A significant difference (P<0.001) was observed between the median value of fecal calprotectin in Irritable Bowel Syndrome group that was 50.5 µg/g (IQR=16 - 294 µg/g); 405 µg/g (IQR=29 - 1980 µg/g) in Crohn’s disease patients and 457 µg/g (IQR=25 - 1430 µg/g) in ulcerative colitis patients. No difference was observed between the values found in the patients with Crohn’s disease and ulcerative colitis. Levels of fecal calprotectin were significantly lower in patients with inflammatory bowel diseases in remission when compared with active disease (P<0.001). Conclusions The present study showed that the determination of fecal calprotectin assists to differentiate between active and inactive inflammatory bowel diseases and between inflammatory bowel diseases and irritable bowel syndrome.

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P319 Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohn's disease with fecal calprotectin

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjx002.444 ◽

2017 ◽

Vol 11 (suppl_1) ◽

pp. S239-S239 ◽

Cited By ~ 1

Author(s):

J.M. Vázquez-Morόn ◽

B. Benítez-Rodríguez ◽

H. Pallarés-Manrique ◽

F.H. Machancoses ◽

J.L. Robles Rodríguez ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Fecal Calprotectin ◽

Mucosal Healing

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Su1907 – Diagnostic Accuracy of the Serum-Based Mucosal Healing Index Assay in Crohn’s Disease and Comparative Accuracy to Fecal Calprotectin in Routine Practice

Gastroenterology ◽

10.1016/s0016-5085(19)38544-0 ◽

2019 ◽

Vol 156 (6) ◽

pp. S-655-S-656

Author(s):

Robert Battat ◽

Brigid S. Boland ◽

Siddharth Singh ◽

Angelina Collins ◽

Elisabeth Evans ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Diagnostic Accuracy ◽

Fecal Calprotectin ◽

Mucosal Healing ◽

Routine Practice ◽

Healing Index ◽

Comparative Accuracy

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P.07.36 REAL-WORLD EVIDENCE OF VEDOLIZUMAB THERAPY IN ULCERATIVE COLITIS AND CROHN'S DISEASE PATIENTS: FECAL CALPROTECTIN A VALID BIOMARKER OF MUCOSAL INFLAMMATION

Digestive and Liver Disease ◽

10.1016/s1590-8658(19)30485-2 ◽

2019 ◽

Vol 51 ◽

pp. e239

Author(s):

C. Cicerone ◽

I. Luppino ◽

M. Erboso ◽

P. Paese ◽

P. Leo

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Real World ◽

Fecal Calprotectin ◽

Mucosal Inflammation ◽

Real World Evidence

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Letter: mucosal healing in ulcerative colitis - higher relevance than in Crohn's disease? Authors' reply

Alimentary Pharmacology & Therapeutics ◽

10.1111/apt.12361 ◽

2013 ◽

Vol 38 (2) ◽

pp. 208-208

Author(s):

D. Laharie ◽

J. Filippi ◽

X. Roblin ◽

S. Nancey ◽

L. Peyrin-Biroulet

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Mucosal Healing

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Mo1880 Mucosal Healing and Dysplasia Surveillance in a Large Referral Center Cohort of Patients With Crohn's Disease and Ulcerative Colitis Treated With Vedolizumab

Gastroenterology ◽

10.1016/s0016-5085(16)32722-6 ◽

2016 ◽

Vol 150 (4) ◽

pp. S804 ◽

Cited By ~ 2

Author(s):

Maja Noman ◽

Marc Ferrante ◽

Raf Bisschops ◽

Gert De Hertogh ◽

Karolien Van den Broeck ◽

...

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Mucosal Healing ◽

Referral Center

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P138 Platelet-to-lymphocyte ratio index: a reliable tool for non-invasive assessment of endoscopic activity in small bowel Crohn’s Disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.265 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S225-S225

Author(s):

V Macedo Silva ◽

M Freitas ◽

S Xavier ◽

T Cúrdia Gonçalves ◽

P Boal Carvalho ◽

...

Keyword(s):

Crohn’S Disease ◽

Small Bowel ◽

Crohn's Disease ◽

Fecal Calprotectin ◽

Mucosal Healing ◽

C Reactive Protein ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Reactive Protein ◽

Non Invasive

Abstract Background The platelet-to-lymphocyte ratio (PLR) index has been a recent focus of investigation as a reliable marker of inflammation. This score was recently shown to have a good accuracy upon predicting endoscopic remission in patients with colonic Crohn’s Disease (CD). We aimed to assess the discriminative power of PLR index in patients with isolated small bowel CD. Methods Single center study of consecutive patients with isolated small bowel CD (L1 ± L4 disease according to Montreal classification) who underwent small bowel capsule endoscopy (SBCE) for assessment of endoscopic activity between January 2019 and December 2020. Only complete SBCEs were considered. CD endoscopic activity was classified according to the Lewis score (LS) value. Complete blood count, C-reactive protein and fecal calprotectin values were collected within 1 month of SBCE. Results Final sample included 49 patients, 35 (71.4%) of them females, with a mean age of 35.1±11.8 years. SBCE reported mucosal healing (LS<135) in 30.6% of the patients; mild activity (135≤LS<790) in 42.9% and moderate-to-severe activity (LS≥790) in 26.5% of the patients. PLR index positive correlation with LS was significant and moderate (k=0.597; p<0.001). This correlation was stronger than the one seen between fecal calprotectin (k=0.525; p=0.001) or C-reactive protein (k=0.321; p=0.029) and the LS score. In particular, PLR index presented an excellent accuracy for predicting patients with a moderate-to-severe endoscopic activity (AUC=0.908; 95%CI=0.816–0.999; p<0.001), with an optimal cut-off of PLR above 157 (sensitivity 92.3%; specificity 82.9%). The accuracy for prediction of mucosal healing was good (AUC=0.743; 95%CI=0.600–0.887; p=0.007), with an optimal cut-off of PLR below 126 (sensitivity 66.7%; specificity 80.0%). Conclusion PLR index demonstrated an excellent acuity for predicting patients with moderate to severe disease in small bowel CD. Moreover, it also demonstrated good acuity for predicting mucosal healing on this set of patients. These results come from a significant correlation of PLR index with endoscopic activity in small bowel CD. Our findings establish this index as a promising and easy-to-apply tool for non-invasive and regular follow-up of patients with small bowel CD.

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The role of the intestinal ultrasound in Crohn’s disease diagnosis and monitoring

Journal of Medicine and Life ◽

10.25122/jml-2021-0067 ◽

2021 ◽

Vol 14 (3) ◽

pp. 310-315

Author(s):

Norbert Dacian Stenczel ◽

◽

Monica Roxana Purcarea ◽

Laura Carina Tribus ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Economic Status ◽

Therapy Response ◽

Disease Diagnosis ◽

Fecal Calprotectin ◽

Mucosal Healing ◽

Clinical Severity ◽

Severity Scores ◽

Ultrasound Parameters

Crohn’s disease is characterized by persistent or recurrent chronic inflammation that may affect any segment of the gastrointestinal tract. It has an oscillating evolution, with periods of activity alternating with periods of remission. Crohn’s disease has a significant impact on the economic status due to its increasing prevalence, often affecting young people. Suitable management for these patients involves frequent evaluations. Even though colonoscopy is the gold standard for the assessment of severity and mucosal healing, it is an invasive maneuver, not easily accepted by patients, and it does not have good repeatability. Intestinal ultrasound has the advantage of being non-irradiating, non-invasive, well-tolerated, cheap, and easy to repeat. Ultrasound parameters such as bowel wall thickness, intestinal wall architecture, intramural vascularisation, proliferation of mesenteric fatty conjunctive tissue, and intraperitoneal fluid can provide good information regarding the severity of the disease, the differentiation between remission and relapse, and its complications. Some of the latest studies show good correlations between ultrasound parameters and inflammation markers (C-reactive protein, fecal calprotectin) and clinical severity scores of Crohn’s disease. Consequently, the importance of intestinal ultrasound has increased lately, and recent studies support its use to evaluate the severity of inflammation, differentiate between active disease and relapse, monitor therapy response and guide treatment, evaluate prognosis, and diagnose complications.

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