IMPACT OF FECAL CALPROTECTIN MEASUREMENT FOR THE DIAGNOSIS OF
INFLAMMATORY BOWEL DISEASE IN CHILDREN WITH ALARM SYMPTOMS
Abstract
Background: Discrimination of inflammatory bowel diseases (IBD) and
other gastrointestinal diseases in pediatric patients is highly
important and the definitive diagnosis of IBD is established by
endoscopic examination. the use of noninvasive methods (clinical
symptoms and laboratory tests) allows an early and accurate referral of
patients from first step health centers to advanced health centers. In
the present study, we aimed to investigate the effectiveness of fecal
calprotectin (FC) in the discrimination of IBD and other
gastrointestinal diseases in children. Methods: The retrospective study
included the patients that underwent FC testing and colonoscopy.
Demographic characteristics, Alarm symptoms (AS), and abnormal
laboratory findings (ALF) were recorded for each patient. A negative
calprotectin result was considered to be less than 50 μg/g, and a second
cutoff value for FC was accepted as 150 µg/g. Definitive diagnosis was
established by colonoscopy in each patient. Results: The study included
88 consecutive patients (mean age, 10.2 ± 6.1 years; 51.1% female). Of
these, 20 (22.7%) patients were diagnosed with IBD. No significant
difference was found between IBD and non-IBD patients with regard to AS
except for involuntary weight loss (p=<0.001). The incidence
of increased CRP and hypoalbuminemia was significantly higher in IBD
patients (p=0.002 and p=0.026, respectively). AS combined with ALF and
FC >150 µg/g had the highest specificity (95.12%).
Conclusions: Although primary care clinicians often use AS and
laboratory parameters in the discrimination of IBD and non-IBD diseases,
FC was found to have a relatively higher diagnostic value.