P101 Fecal calprotectin is increased among patients with pouchitis and increases with increasing endoscopic subscores: Real-world data from a prospectively collected database

Abstract Background An accurate and non-invasive surrogate marker of inflammation is needed for managing patients after Ileal pouch-anal anastomosis (IPAA). In this study, we evaluate the performance of fecal calprotectin (FC) in patients with ulcerative colitis (UC) who underwent IPAA and were assessed with clinical, endoscopic, and histologic examination of the pouch. Methods Medical records of patients who underwent IPAA with J-pouch formation registered in a prospectively collected database at the Tel Aviv Sourasky Medical Center, Israel, were evaluated. Clinical, endoscopic, histologic, and laboratory data were extracted. Each pouch evaluation was regarded separately. Pouchitis was defined as a Pouchitis Disease Activity Score (PDAI) of ≥7 (maximum score: 18). Results One hundred and fifty-six patients underwent 296 unique pouch evaluations. Fifty-two percent of patients were male, the median age at the time of evaluation was 43 years (IQR 35–58), and the median pouch age from the closure of the ileostomy was 10 years (IQR 2.5–15). The median [IQR] FC values were significantly lower in patients without pouchitis than in patients with pouchitis (208 [96–478] vs. 550 [250–1051] ug/g, p<0.0001). Mean FC values were lower in patients with lower endoscopic and histologic scores when compared to higher scores, with a significant linear trend for higher FC levels with increasing endoscopic and histologic disease activity. FC performed better than CRP as a predictor of pouchitis. A FC of over 400 ug/g had over 80% specificity for predicting significant endoscopic disease. Conclusion FC levels increase among patients with pouchitis and increase with increasing endoscopic and histologic inflammation. A FC of over 400 ug/g had good discriminative ability as a predictor of significant endoscopic disease. We suggest that in patients with symptoms of pouchitis and an FC level above 400 ug/g, antibiotic treatment can be initiated without awaiting pouchoscopy. Further research is needed to define FC concentrations more precisely among various outcome measures of interest in these patients.

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Relationship between Microalbuminuria and Disease Activity in Patients with Ulcerative Colitis

Middle East Journal of Digestive Diseases ◽

10.15171/mejdd.2020.161 ◽

2019 ◽

Vol 12 (1) ◽

pp. 34-38

Author(s):

Kourosh Masnadi Shirazi ◽

Sima Khayati ◽

Maryam Baradaran Binazir ◽

Zeinab Nikniaz

Keyword(s):

Ulcerative Colitis ◽

Disease Activity ◽

Activity Index ◽

Disease Activity Index ◽

Fecal Calprotectin ◽

Cross Sectional Study ◽

Inactive Disease ◽

Cross Sectional ◽

Non Invasive ◽

The Mean

BACKGROUND Introducing a non-invasive method for determining disease activity is important in patients with ulcerative colitis (UC). So in this study, we aimed to assess the association between disease activity index and microalbuminuria in patients with UC. METHODS In the present cross-sectional study, 84 patients with UC were selected. The disease activity was calculated by the partial Mayo clinic score. Microalbuminuria was assessed using the immunoturbidimetric method in a first-voided sample in the morning in two consecutive days and the mean of these two measurements was reported as urinary microalbumin level. Serum C reactive protein (CRP), erythrocyte sedimentation rate (ESR), and fecal calprotectin were measured respectively using conventional turbidimetric immunoassay, Westergren method, and ELISA methods. RESULTS The mean age of the participants was 40.01 ± 12.85 years, 60.8% of them were female and 53.5% had microalbuminuria. The frequency of microalbuminuria was significantly higher in patients with active compared with inactive inflammatory bowel disease (IBD). There were significant differences between the patients with active and inactive disease regarding CRP, ESR, and calprotectin (p < 0.001). Moreover, there was a strong correlation between microalbuminuria and CRP (r = 0.89, p < 0.001), ESR (r = 0.92, p < 0.001), and calprotectin (r = 0.91, p < 0.001). CONCLUSION Microalbuminuria could be used as a non-invasive marker of disease activity in patients with UC.

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Comparative Evaluation of Fecal Calprotectin and S100A12 as Non-Invasive Markers for Disease Activity in Inflammatory Bowel Disease

Gastroenterology ◽

10.1016/s0016-5085(11)61768-x ◽

2011 ◽

Vol 140 (5) ◽

pp. S-431 ◽

Cited By ~ 1

Author(s):

Claudia Berger ◽

Stefan Marcel Loitsch ◽

Franz Hartmann ◽

Axel U. Dignass ◽

Jürgen Stein

Keyword(s):

Inflammatory Bowel Disease ◽

Disease Activity ◽

Bowel Disease ◽

Comparative Evaluation ◽

Fecal Calprotectin ◽

Non Invasive ◽

Inflammatory Bowel

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Comparative evaluation of fecal calprotectin and S100A12 as non-invasive markers for disease activity in inflammatory bowel diseas

Zeitschrift für Gastroenterologie ◽

10.1055/s-0031-1285356 ◽

2011 ◽

Vol 49 (08) ◽

Author(s):

C Berger ◽

SM Loitsch ◽

F Hartmann ◽

A Dignass ◽

J Stein

Keyword(s):

Disease Activity ◽

Comparative Evaluation ◽

Fecal Calprotectin ◽

Non Invasive ◽

Inflammatory Bowel

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Fecal Calprotectin In Allogeneic Stem Cell Trasplantation as Surrogate Marker of Gastrointestinal Graft Versus Host Disease

Blood ◽

10.1182/blood.v116.21.2327.2327 ◽

2010 ◽

Vol 116 (21) ◽

pp. 2327-2327

Author(s):

Mariana Bastos Oreiro ◽

Ana Lopez de la Guia ◽

Jose B Nieto ◽

Raquel De Paz ◽

Patricia Baltasar ◽

...

Keyword(s):

Graft Versus Host Disease ◽

Predictive Value ◽

Intestinal Inflammation ◽

Intestinal Parasites ◽

Conditioning Regimen ◽

Surrogate Marker ◽

Fecal Calprotectin ◽

Host Disease ◽

Graft Versus Host ◽

Non Invasive

Abstract Abstract 2327 Background: Calprotectin is a major cytosolic protein of neutrophils that have showed to be a sensitive marker of intestinal inflammation. The aim of our study has been to evaluate fecal calprotectin (FC) as a diagnosis tool in patients with acute gastrointestinal graft versus host disease (GI GVHD). Methods: Since March 2009, patients with suspicion of acute GI GVHD were consecutively included. Patients were tested for FC (reference range: 0–30 mg/kg) before starting treatment. Infections by Clostridium difficile, cytomegalovirus, fecal bacteria and intestinal parasites were also excluded. Colonoscopy was performed in all patients and biopsy samples were taken for histopathological examination. Results: To date, eleven patients have been included. The median age was 48.2 (r: 21–67). Indications for transplantation included acute myeloid leukemia (6 patients), myelodysplastic syndrome (2 patients), acute lymphoid leukemia, severe aplastic anemia and refractory follicular lymphoma (1 patient, respectively). Ten patients received myeloablative conditioning and one received reduced intensity conditioning regimen. Five patients were histologically diagnosed with acute GI GVHD. The median for FC in this group was 510.5 (r: 107.4–629). The median of FC in patients without GI GVHD was 117 (r: 13.9–205). Patients with GI GVHD had higher values of FC than patients without GI GVHD (p:≤0,009) For a cut-off point value of 205, sensitivity for the test was 83.3% (IC 61.3–100%), specificity was 100%, positive predictive value was 100%, and negative predictive value was 83.3% (IC 61.3–100%). In 3 patients who were diagnosed with cytomegalovirus enteritis and had no criteria for GI GVHD, the FC values were 15.4, 105, and 100.7. In a patient with Candida spp. infection FC was 13.9. The FC was higher in patients with grade IV GI GVHD, with median of 590 (r: 502–629). Conclusion: FC appears to be a promising non-invasive biomarker of acute GI GVHD. If these findings are confirmed, it may provide a useful non-invasive test for the diagnosis of GI GVHD in patients following allogeneic transplantation. Disclosures: No relevant conflicts of interest to declare.

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P149 Ulcerative colitis patients with high calprotectin levels should undergo endoscopy within 7 days for therapeutic decision

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.278 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S212-S212

Author(s):

J O Kim ◽

S R Jeon ◽

H Park ◽

H G Kim ◽

B M Ko ◽

...

Keyword(s):

Ulcerative Colitis ◽

Disease Activity ◽

Surrogate Marker ◽

Fecal Calprotectin ◽

Youden Index ◽

Optimal Time ◽

Time Interval ◽

Therapeutic Decision ◽

Index Method ◽

The Mean

Abstract Background Fecal calprotectin (FC) has considered as a useful surrogate marker to predict which patients with ulcerative colitis (UC) are in endoscopic activity. FC has to be collected at the time of endoscopy for more accurate correlation between FC and endoscopic disease activity. In real practice, however, both tests cannot be easy to perform at the same time. Therefore, the aim of this study was to evaluate the optimal time interval for the correlation between FC and endoscopic disease activity in UC patients. Methods We analysed retrospectively 103 cases (79 patients) that was performed FC measurement and endoscopy within 3 months. FC quantitative tests was defined as normal (<100 μg/g), mild (100–200, 100–250 or 100–300 μg/g), and moderate to severe activity (>200, > 250, or > 300 μg/g). Endoscopic activity was graded using the Mayo endoscopic subscore (MES). After assessing concordance between FC level and MES, we use the youden index method to estimate the optimal time interval between both tests using the receiver operator curves (ROCs). Results Among 79 UC patients, 64.5% (51/79) were male. The mean FC level was 673.6 ± 1054 μg/g. The mean interval between FC measurement and endoscopy was 13.8 ± 22.7 days. FC levels and MES were positively correlated (r = 0.473, p < 0.001). Using a ROC curve with a cut off value of FC 200 μg/g, the optimal cut-off of the time interval for separation of non-correlation and correlation between FC level and MES was 7 days with a sensitivity of 74.4% and a specificity of 50.0% (AUC 0.6032; 95% CI 0.4779–0.6896). Similarly, using ROC curves with a cut off value of FC 250 or 300 μg/g as a standard for dividing mild and moderate, the optimal cut-off of the time interval were all 5.5 days (FC 250, sensitivity 71.7%, specificity 49.1, AUC 0.5862, 95% CI 0.4728–0.6884; FC 300, sensitivity 69.6%, specificity 47.4, AUC 0.5549, 95% CI 0.4668–0.6513). Conclusion FC level within 7 days could reflect endoscopic disease activity in patients with UC. In patients with high-level FC more than 200 μg/g, endoscopic evaluation for therapeutic decision making should be performed within a maximum of 7 days.

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Role of Fecal Calprotectin as a Noninvasive Indicator for Ulcerative Colitis Disease Activity

Folia Medica ◽

10.2478/folmed-2018-0071 ◽

2019 ◽

Vol 61 (2) ◽

pp. 188-196 ◽

Cited By ~ 1

Author(s):

Radislav V. Nakov ◽

Ventsislav N. Nakov ◽

Vanya A. Gerova ◽

Lyudmila T. Tankova

Keyword(s):

Ulcerative Colitis ◽

Disease Activity ◽

Intestinal Inflammation ◽

Point Of Care ◽

Fecal Calprotectin ◽

Non Invasive ◽

Significant Difference ◽

Endoscopic Score ◽

Index Of Severity

Abstract Background: It is essential in clinical management to determine the disease activity in ulcerative colitis (UC) patients. At present, the most accurate way of evaluating the UC severity is endoscopy with biopsy. Fecal calprotectin (FCP) is a non-invasive biomarker that is frequently used for monitoring of intestinal inflammation. Aims: The purpose of our study was to assess the role of FCP as a noninvasive indicator for UC disease activity. Materials and methods: This prospective study enrolled 116 patients with UC (56 with quiescent UC and 60 with active UC) and 36 controls, referred for colonoscopy to our Center. Colonoscopy was performed in all the patients and the findings were graded according to Mayo endoscopic score (EMS) and UC endoscopic index of severity (UCEIS). FCP was analyzed in stool samples by means of point-of-care desk-top Quantum Blue® method. Results: There was no significant difference between mean FCP levels in controls and UC patients in remission (р=0.205). Mean FCP in patients with active UC was significantly higher than that in controls (p<0.001) and in patients in remission (p<0.001). FCP significantly correlated with UCEIS (r = 0.869, p<0.001) and EMS (r = 0.814, p<0.001). Conclusion: The strong correlation with endoscopic disease activity suggests that FCP is a useful biomarker for noninvasive diagnosis and monitoring of disease activity in UC patients.

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