P211 Pseudopolyps are associated with increased fecal calprotectin levels in patients with Inflammatory Bowel Disease in clinical and endoscopic remission

Abstract Background Fecal calprotectin (FC) has become a fundamental tool in the non-invasive monitorization of activity in patients with inflammatory bowel diseases (IBD). However, there is still debate over the choice of the optimal cut-off point for the different clinical settings. The aim of this study is to analyze whether the presence of pseudopolyps and their characteristics have an impact on the value of FC and should therefore be taken into account when deciding the optimal cutoff values. Methods A single-centered, retrospective analysis including data from patients with colonic Crohn′s disease or Ulcerative colitis who underwent colonoscopy for dysplasia screening at our center between 2018 and 2019. Patients that did not have a FC registered within 8 months from to the colonoscopy, or that did not maintain clinical remission between the colonoscopy and the measurement of the FC, were excluded. Patients that had activity in the colonoscopy (Mayo endoscopic score >0, SESCD >0) were also excluded. Results 73 patients were included. 26 (35.6%) of them had pseudopolyps in the colonoscopy. The median value of the FC was significantly different in patients with pseudopolyps (110.1 µg/g, CI 95% [48.6–171.5]) compared to those without them (52.5 µg/g, CI 95% [29.9–75.1]). In 11 (42.3%) of the patients with pseudopolyps, biopsies were taken, observing histological activity in 3 of them (27.3%) and no inflammatory activity in the other 8 (72.7%). We found that FC was higher in patients with inflammatory polyps (119.0 µg/g) in comparison to those without histological activity in their pseudopolyps (96.9 µg/g); however, these results were not statistically significant. The location of the pseudopolyps had no influence over the FC in our study. In addition, no correlation was found between the presence of polyps or diverticula and FC. Conclusion In our study, the presence of pseudopolyps is associated with significantly higher levels of FC. Moreover, our results suggest a tendency towards higher FC in patients who had active colitis in the histological samples of their pseudopolyps.

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Fecal calprotectin in inflammatory bowel diseases: update and perspectives

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2016-0522 ◽

2017 ◽

Vol 55 (4) ◽

Cited By ~ 29

Author(s):

Hana Manceau ◽

Valérie Chicha-Cattoir ◽

Hervé Puy ◽

Katell Peoc’h

Keyword(s):

Inflammatory Bowel Diseases ◽

Therapeutic Response ◽

Fecal Calprotectin ◽

Intestinal Wall ◽

Therapeutic Monitoring ◽

Non Invasive ◽

Bowel Diseases ◽

Calprotectin Level ◽

Inflammatory Bowel

AbstractInflammatory bowel diseases (IBDs) are chronic diseases that result from the inflammation of the intestinal wall, suspected in any patient presenting with intestinal symptoms. Until recently, the diagnosis was mainly based on both clinical and endoscopic arguments. The use of an easy, fast, reliable, non-invasive, and inexpensive biological assay is mandatory not only in diagnosis but also in evolutionary and therapeutic monitoring. To date, the fecal calprotectin is the most documented in this perspective. This marker allows the discrimination between functional and organic bowel processes with good performance. The determination of the fecal calprotectin level contributes to the evaluation of the degree of disease activity and to monitoring of therapeutic response.

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The usefulness of fecal calprotectin testing in pediatric gastroenterology clinical practice

Medical Principles and Practice ◽

10.1159/000512631 ◽

2020 ◽

Author(s):

Eliza Lężyk-Ciemniak ◽

Magdalena Tworkiewicz ◽

Dominika Wilczyńska ◽

Anna Szaflarska-Popławska ◽

Aneta Krogulska

Keyword(s):

Gastrointestinal Tract ◽

Intestinal Inflammation ◽

Fecal Calprotectin ◽

Diagnostic Methods ◽

Delay In Diagnosis ◽

Number Of Children ◽

Non Invasive ◽

Course Of Action ◽

Bowel Diseases ◽

Inflammatory Bowel

Abstract Gastrointestinal tract symptoms such as abdominal pain, constipation, diarrhea, and fever are frequent causes of visits to the pediatrician. The increasing prevalence of chronic gastrointestinal tract diseases, and the falling median age of their onset, indicate the need to identify new diagnostic methods that can differentiate inflammatory bowel diseases from other gastrointestinal tract conditions. A promising non-invasive and useful marker of intestinal inflammation is fecal calprotectin. The manuscript summarizes currently available information on the use of fecal calprotectin in the diagnosis and monitoring of inflammatory bowel disease in children. It also attempts to determine the effect of concentration on its course of action. Incorporating fecal calprotectin (FC) testing within the framework of primary medical care can decrease the number of children unnecessarily referred for endoscopic or radiologic examination. FC screening benefits patients by reducing any delay in diagnosis and avoiding unnecessary exposure to endoscopy, and benefits physicians by reducing pressure on endoscopy testing and assisting the decision. The present paper emphasizes the role of fecal calprotectin as a non-invasive marker for monitoring disease activity and efficacy of therapy, and predicting postoperative relapses, primarily in patients with IBD.

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Sarcopenia, severe anxiety and increased C-reactive protein are associated with severe fatigue in patients with inflammatory bowel diseases

Scientific Reports ◽

10.1038/s41598-021-94685-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Laura Tasson ◽

Fabiana Zingone ◽

Brigida Barberio ◽

Romina Valentini ◽

Pamela Ballotta ◽

...

Keyword(s):

Fecal Calprotectin ◽

Healthy Population ◽

C Reactive Protein ◽

Reactive Protein ◽

Severe Fatigue ◽

High Prevalence ◽

Bowel Diseases ◽

Moderate Fatigue ◽

Inflammatory Bowel ◽

Severe Anxiety

AbstractPatients with inflammatory bowel disease (IBD) report fatigue more frequently than healthy population, but the precise mechanisms underlying its presence are unknown. This study aimed to evaluate the prevalence of fatigue in IBD and its relation with potential causative factors. A survey on fatigue, depression, anxiety, sleep disorders, and the presence of sarcopenia and malnutrition, was sent by email to 244 IBD outpatients of the Gastroenterology Unit of Academic Hospital of Padua. Demographics and clinical data, including the levels of fecal calprotectin (FC) and C-reactive protein (CRP), and current pharmacological treatments were obtained from patients’ medical records. Ninety-nine (40.5%) subjects answered the survey. Ninety-two (92.9%) patients reported fatigue, with sixty-six having mild to moderate fatigue and twenty-six severe fatigue. Multivariate analysis showed that abnormal values of CRP (OR 5.1), severe anxiety (OR 3.7) and sarcopenia (OR 4.4) were the factors independently associated with severe fatigue. Fatigue has a high prevalence in subject affected by IBD. Subjects with altered CRP, sarcopenia and severe anxiety appear more at risk of severe fatigue.

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International consensus on methodological issues in standardization of fecal calprotectin measurement in inflammatory bowel diseases

United European Gastroenterology Journal ◽

10.1002/ueg2.12069 ◽

2021 ◽

Author(s):

Ferdinando D'Amico ◽

David T. Rubin ◽

Paulo Gustavo Kotze ◽

Fernando Magro ◽

Britta Siegmund ◽

...

Keyword(s):

Inflammatory Bowel Diseases ◽

Fecal Calprotectin ◽

Methodological Issues ◽

International Consensus ◽

Bowel Diseases ◽

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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FECAL CALPROTECTIN: levels for the ethiological diagnosis in Brazilian patients with gastrointestinal symptoms

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032015000100011 ◽

2015 ◽

Vol 52 (1) ◽

pp. 50-54 ◽

Cited By ~ 8

Author(s):

Lorete Maria da Silva KOTZE ◽

Renato Mitsunori NISIHARA ◽

Sandra Beatriz MARION ◽

Murilo Franco CAVASSANI ◽

Paulo Gustavo KOTZE

Keyword(s):

Ulcerative Colitis ◽

Irritable Bowel Syndrome ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Inflammatory Bowel Diseases ◽

Fecal Calprotectin ◽

Bowel Diseases ◽

Inflammatory Bowel ◽

Irritable Bowel ◽

Active 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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Setting up a Virtual Calprotectin Clinic in Inflammatory Bowel Diseases: Literature Review and Nancy Experience

Journal of Clinical Medicine ◽

10.3390/jcm9092697 ◽

2020 ◽

Vol 9 (9) ◽

pp. 2697

Author(s):

Ferdinando D’Amico ◽

Patrick Netter ◽

Cedric Baumann ◽

Muriel Veltin ◽

Camille Zallot ◽

...

Keyword(s):

Inflammatory Bowel Diseases ◽

Recent Literature ◽

Fecal Calprotectin ◽

University Hospital ◽

Treat To Target ◽

Adherence Rate ◽

Patient’S Satisfaction ◽

Bowel Diseases ◽

Inflammatory Bowel ◽

Home Tests

Technological progress, including virtual clinics, web or smartphone-based applications, and assessment of fecal calprotectin (FC) at home has favored the implementation of treat to target strategies for patients with inflammatory bowel diseases (IBD). Although these innovations are promising and have been associated with a significant reduction in health costs, their application in clinical practice is limited. Here, we summarize the most recent literature on virtual clinics and available FC home tests. In addition, we report the experience of IBD patients monitored through the IBDoc® test at the Nancy University Hospital, focusing on usability testing and patient’s satisfaction. This pilot experience shows that a virtual calprotectin clinic doubles adherence rate to FC in IBD patients. This finding is especially clinically relevant in the post-coronavirus disease 2019 (COVID-19) pandemic era, with an increasing use of e-health.

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Effectiveness of Mediterranean Diet’s Adherence in Children with Inflammatory Bowel Diseases

Nutrients ◽

10.3390/nu12103206 ◽

2020 ◽

Vol 12 (10) ◽

pp. 3206 ◽

Cited By ~ 2

Author(s):

Caterina Strisciuglio ◽

Sabrina Cenni ◽

Maria Rosaria Serra ◽

Pasquale Dolce ◽

Massimo Martinelli ◽

...

Keyword(s):

Mediterranean Diet ◽

Protein Intake ◽

Intestinal Inflammation ◽

Fecal Calprotectin ◽

Dietary Intakes ◽

Food Diary ◽

Significant Difference ◽

Bowel Diseases ◽

Inflammatory Bowel ◽

The Mediterranean

Background: Nutritional support is very important in the treatment of Paediatric Inflammatory Bowel Disease (IBD). The role of the Mediterranean Diet (MD) has been understudied in children with IBD. The aims of this study were to assess the dietary intakes of IBD children in comparison with healthy controls (HCs), their adherence to MD; and the relationship between inflammation and dietary behaviors. Methods: Paediatric IBD patients in clinical remission and HCs were enrolled. The nutritional status and adherence to the Mediterranean Diet was evaluated through a 3-day food diary and the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED). Results: The analysis of food diaries showed a significantly higher kilocalorie intake in IBD patients compared to HCs (p = 0.012), an increase in carbohydrates (p = 0.015) and in protein intake (p = 0.024). Both IBD and HCs have an intermediate adherence to MD. The comparison between Crohn’s disease (CD) and Ulcerative colitis (UC) patients showed significant difference in protein intake in CD patients (p = 0.047), as well as for vitamin D (p = 0.044) and iron intake (p = 0.023). Interestingly; in IBD patients we found a significant association between adherence to MD and a low level of fecal calprotectin (p = 0.027). Conclusion: Children with IBD in remission have a sub-optimal food intake compared to HCs. MD seems to correlate to decreased intestinal inflammation.

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