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

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.

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

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.

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

2011 ◽  
Vol 140 (5) ◽  
pp. S-431 ◽  
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

Small intestinal sampling capsule for inflammatory bowel disease type detection and management

Lab on a Chip ◽  
2021 ◽  
Author(s):  
Sina Nejati ◽  
Jiangshan Wang ◽  
Ulisses Heredia-Rivera ◽  
Sotoudeh Sedaghat ◽  
Ian Woodhouse ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Small Intestine ◽  
Bowel Disease ◽  
Fecal Calprotectin ◽  
Disease Type ◽  
Non Invasive ◽  
Inflammatory Bowel ◽  
Small Intestinal

A non-invasive sampling capsule is introduced to site-selectively collect calprotectin biomarker from the small intestine. This approach can be accompanied with the fecal calprotectin assay to diagnose IBD and differentiate its types (CD and UC).

scholarly journals FECAL CALPROTECTIN AND MICROBIOTA OF THE GUT

2016 ◽  
Vol 1 (4) ◽  
pp. 145-149
Author(s):  
Богородская ◽  
Svetlana Bogorodskaya ◽  
Чашкова ◽  
Elena Chashkova ◽  
Горохова ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clinical Practice ◽  
Intestinal Microbiota ◽  
Bowel Disease ◽  
Fecal Calprotectin ◽  
Non Invasive ◽  
Inflammatory Bowel

Analysis of the literature and our research showed that an imbalance of the intestinal microbiota is associated with many diseases. We present some of the mechanisms of disease. Using non-invasive, simple, affordable method of deter-mination of fecal calprotectin reveals the presence and progression of chronic non-specific inflammatory bowel disease, and can be widely used in clinical practice

Systematic Review: Gastrointestinal Ultrasound Scoring Indices for Inflammatory Bowel Disease

2020 ◽  
Author(s):  
Thomas M Goodsall ◽  
Tran M Nguyen ◽  
Claire E Parker ◽  
Christopher Ma ◽  
Jane M Andrews ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Positive Predictive Value ◽  
Bowel Disease ◽  
Predictive Value ◽  
Bowel Wall ◽  
Risk Of Bias ◽  
Gastrointestinal Ultrasound ◽  
Inflammatory Bowel ◽  
Sensitivity Specificity ◽  
Index Components

Abstract Background and Aims Serial measurements of luminal disease activity may facilitate inflammatory bowel disease management. Gastrointestinal ultrasound is an easily performed, non-invasive alternative to other assessment modes. However, its widespread use is limited by concerns regarding validity, reliability, and responsiveness. We systematically identified ultrasound scoring indices used to evaluate inflammatory bowel disease activity and examine their operating characteristics. Methods Electronic databases were searched from inception to June 14, 2019 using pre-defined terms. Studies that reported on gastrointestinal ultrasound index operating properties in an inflammatory bowel disease population were eligible for inclusion. Study characteristics, index components, and operating property data [ie, validity, reliability, responsiveness, sensitivity, specificity, accuracy, positive predictive value, and negative predictive value] were extracted. The QUADAS-2 tool was used to examine study-level risk of bias. Results Of the 2610 studies identified, 26 studies reporting on 21 ultrasound indices were included. The most common index components included bowel wall thickness, colour Doppler imaging, and bowel wall stratification. The correlation between ultrasound indices and references standards ranged r = 0.62–0.95 and k = 0.40–0.96. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive values ranged 39–100%, 63–100%, 73–100%, 57–100%, and 40–100%, respectively. Reliability and responsiveness data were limited. Most [92%, 24/26] studies received at least one unclear or high risk of bias rating. Conclusions Several gastrointestinal ultrasound indices for use in inflammatory bowel disease have been developed. Future research should focus on fully validating existing or novel gastrointestinal ultrasound scoring instruments for assessment of Crohn’s disease and ulcerative colitis.

scholarly journals Fecal Calprotectin in Assessing Inflammatory Bowel Disease Endoscopic Activity: a Diagnostic Accuracy Meta-analysis

2018 ◽  
Vol 27 (3) ◽  
pp. 299-306 ◽  
Author(s):  
Theodore Rokkas ◽  
Piero Portincasa ◽  
Ioannis E Koutroubakis
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Meta Analysis ◽  
Group Analysis ◽  
Fecal Calprotectin ◽  
Significant Heterogeneity ◽  
Likelihood Ratios ◽  
Random Effects Models ◽  
Inflammatory Bowel ◽  
Sensitivity Specificity

Background & Aim: Fecal calprotectin (FC) has been suggested as a sensitive biomarker of inflammatory bowel disease (IBD). However, its usefulness in assessing IBD activity needs to be more precisely defined. In this meta-analysis we aimed to determine the diagnostic performance of FC in assessing IBD endoscopic activity in adults. Methods: We searched the databases Pubmed/Medline and EMBASE, and studies which examined IBD endoscopic activity in association to FC were identified. From each study pooled data and consequently pooled sensitivity, specificity, likelihood ratios (LR), diagnostic odds ratios (DORs) and areas under the curve (AUCs) were calculated, using suitable meta-analysis software. We analyzed extracted data using fixed or random effects models, as appropriate, depending on the presence of significant heterogeneity. Results: We included 49 sets of data from 25 eligible for meta-analysis studies, with 298 controls and 2,822 IBD patients. Fecal calprotectin in IBD (Crohn’s disease, CD and ulcerative colitis, UC) showed a pooled sensitivity of 85%, specificity of 75%, DOR of 16.3 and AUC of 0.88, in diagnosing active disease. The sub-group analysis revealed that FC performed better in UC than in CD (pooled sensitivity 87.3% vs 82.4%, specificity 77.1% vs 72.1% and AUC 0.91 vs 0.84). Examining the optimum FC cut-off levels, the best sensitivity (90.6%) was achieved at 50 μg/g, whereas the best specificity (78.2%) was found at levels >100 μg/g. Conclusions: This meta-analysis showed that in adults, FC is a reliable laboratory test for assessing endoscopic activity in IBD. Its performance is better in UC than CD.

scholarly journals P214 Faecal S100A12 as a non-invasive marker of inflammatory activity in pediatric Inflammatory Bowel Disease

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S271-S272
Author(s):  
M Casertano ◽  
S Cenni ◽  
A M Caprio ◽  
F Oglio ◽  
D Pacella ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
White Blood Cells ◽  
Fecal Calprotectin ◽  
Inflammatory Activity ◽  
Enzyme Linked Immunosorbent Assay ◽  
Clinical Relapse ◽  
Non Invasive ◽  
Markers Of Inflammation ◽  
Inflammatory Bowel

Abstract Background Calgranulin-C (S100A12) is a new faecal marker of inflammation that is potentially more specific for Inflammatory Bowel Disease (IBD) than calprotectin, since it is only released by activated granulocytes. In recent years it has been confirmed that the S100A12 has comparable sensitivity and specificity to fecal calprotectin (FC) in adult patients with IBD. The aim of our study was to evaluate concentration of faecal S100A12 and calprotectin (FC) to see which of the two tests best correlated to inflammation in IBD children. Methods Between September 2019 and March 2020, we prospectively enrolled all IBD pediatric patients, both Crohn’s Disease (CD) and Ulcerative Colitis (UC). Blood and faecal samples were collected in order to evaluate serological markers of inflammation, faecal S100A12A and FC. S100A12 and FC were determined by enzyme-linked immunosorbent assay (ELISA). Results One hundred seventeen consecutive children, 46 (39%) with CD and 71 (61%) with UC were enrolled in the study. The mean age was 14.6 years (range:5–18), 44% female. Twenty three children were in clinical relapse (20%). No significant differences in S100 A12A levels were found between the UC and the CD groups (mean ±ds 25 ±32mcg/ml vs 34 ±27 mcg/ml respectively, p=0.22).In the UC group we found a statistically significant correlation of both calprotectin and S100A12 with CRP (r=0.253, p=0.044 and r=0.252, p=0.040, respectively). In CD group we found that both calprotectin and S100A12 correlated with hemoglobin (r= -0.343, p=0,024; r=-0.401, p 0.008 respectively), hematocrit (r=-0.361, p=0,046; r=-0.434, p=0.015, respectively), fibrinogen (r=0.499, p&lt; 0,001; r=0.325, p =0.038, respectively), and white blood cells count (r=0.309, p=0.044; r=0.394, p=0.021, respectively). Moreover, in CD group, FC correlated with CRP (r=0.431, p=0.004) and erythrocyte sedimentation rate (r=0.430, p=0.004). Finally, S100A12 correlated with platelet count both in CD and UC group (r=0.351, p=0.021and r=0.254, p=0.038, respectively) IBD children in clinical relapse had higher values ​​of S100A12 and FC than patients in remission (66±47 mcg/ml vs 43±42 mcg/ml, p=0.05 and 260±192 mg/Kg vs 166±169 mg/Kg, p=0.046, respectively) Conclusion Our preliminary data show that both faecal S100A12 and FC are useful non-invasive biomarkers which reflect inflammatory activity of IBD children. Our future aim is to evaluate the correlation of S100A12 and endoscopic finding in order to further clarify its role in the diagnosis and the management of pediatric IBD.

scholarly journals Optimal Range of Fecal Calprotectin for Predicting Mucosal Healing in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-11
Author(s):  
Bing-Jie Xiang ◽  
Min Jiang ◽  
Ming-Jun Sun ◽  
Cong Dai
Keyword(s):  
Inflammatory Bowel Disease ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Sensitivity And Specificity ◽  
Bowel Disease ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Fecal Calprotectin ◽  
Mucosal Healing ◽  
Inflammatory Bowel

<b><i>Objective:</i></b> Fecal calprotectin (FC) is a promising marker for assessment of inflammatory bowel disease (IBD) activity. However, the utility of FC for predicting mucosal healing (MH) of IBD patients has yet to be clearly demonstrated. The objective of our study was to perform a meta-analysis evaluating the diagnostic accuracy of FC in predicting MH of IBD patients. <b><i>Methods:</i></b> We systematically searched the databases for studies from inception to April 2020 that evaluated MH in IBD. The methodological quality of each study was assessed according to the Quality Assessment of Diagnostic Accuracy Studies checklist. The extracted data were pooled using a summary receiver operating characteristic curve model. Random-effects model was used to summarize the diagnostic odds ratio, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. <b><i>Results:</i></b> Sixteen studies comprising 1,682 ulcerative colitis (UC) patients and 4 studies comprising 221 Crohn’s disease (CD) patients were included. The best performance of FC for predicting MH in UC was at cut-off range of 60–75 μg/g with area under the curve (AUC) of 0.88 and pooled sensitivity and specificity of 0.87 and 0.79, respectively. The pooled sensitivity and specificity values of cutoff range 180–250 μg/g for predicting MH in CD were 0.67 and 0.76, respectively. The AUC of 0.79 also revealed improved discrimination for identifying MH in CD with FC concentration. <b><i>Conclusion:</i></b> Our meta-analysis has found that FC is a simple, reliable noninvasive marker for predicting MH in IBD patients. FC cutoff range 60–75 μg/g appears to have the best overall accuracy in UC patients.

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