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Diagnostic value of faecal calprotectin in paediatric gastroenterology clinical practice
R Berni Canani1, L Rapacciuolo, M T Romano
1Department of Pediatrics, University Federico II of Naples, Via S. Pansini, 5, 80131 Naples, Italy. berni@unina.it
Insights
Faecal calprotectin (FC) is a sensitive marker for detecting intestinal inflammation in children. Elevated FC levels help differentiate inflammatory from functional gastrointestinal disorders, aiding diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Clinical Diagnostics
- Biomarker Research
Background:
- Faecal calprotectin (FC) is an emerging biomarker for intestinal inflammation.
- Limited data exists on FC values in pediatric gastroenterology practice.
Purpose of the Study:
- To evaluate FC levels across various pediatric gastrointestinal diseases.
- To compare FC values in diseased children with those in healthy pediatric controls.
Main Methods:
- Study included 281 children with gastrointestinal symptoms and 76 healthy controls.
- Stool samples were analyzed using an ELISA assay.
- Exclusion criteria were applied to healthy controls to ensure accurate baseline data.
Main Results:
- Healthy children had a median FC of 28.0 microg/g (95th percentile: 95.3 microg/g).
- Increased FC concentrations were observed in inflammatory gastrointestinal diseases, notably higher in active inflammatory bowel disease.
- Children with functional bowel disorders or non-inflammatory conditions showed normal FC values.
- An optimized FC cutoff of 102.9266 microg/g was determined to distinguish inflammatory from functional disorders.
Conclusions:
- Calprotectin is a sensitive, though not disease-specific, marker for gastrointestinal inflammation.
- FC aids in identifying organic diseases with mucosal inflammation.
- FC assists in the differential diagnosis between organic and functional bowel disorders in children.
Background:
Faecal calprotectin (FC) is a new marker of intestinal inflammation. Data on FC in paediatric gastroenterology clinical practice are still scarce.
Aims:
To assess FC values in different paediatric gastrointestinal diseases comparing them with those obtained in healthy children.
Patients:
Two hundred and eighty-one children (age range 13-216 months) consecutively referred for gastrointestinal symptoms. Seventy-six healthy controls (age range 13-209 months). The exclusion criteria in healthy children were the following: any known underlying chronic disease or a history of abdominal pain, diarrhoea, acute respiratory tract infection, intake of non-steroidal anti-inflammatory drugs, gastric acidity inhibitors, antibiotics, drugs influencing gut motility, and menstrual or nasal bleeding in the last 3 weeks.
Methods:
Stool samples stored, prepared and analyzed by an ELISA assay.
Results:
In healthy children the median FC value was 28.0 microg/g (15-57 interquartile range) with a 95th percentile value of 95.3 microg/g. An increase in FC concentration was observed in all diseases characterized by gastrointestinal mucosa inflammation, and the active inflammatory bowel disease patients showed the higher FC values. All children affected by functional bowel disorders or by non-inflammatory diseases showed normal values. We calculated an optimized FC cut off value of 102.9266 microg/g (revealed by the receiver operating characteristic curve) to distinguish patients with active organic/inflammatory disorders from healthy subjects and from patients with functional bowel disorders.
Conclusions:
Calprotectin is a sensitive, but not disease specific, marker to easily detect inflammation throughout the whole gastrointestinal tract. It may help in identifying an organic disease characterized by intestinal mucosa inflammation and in the differential diagnosis of functional bowel disorders.
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