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Fecal calprotectin complements routine laboratory investigations in diagnosing childhood inflammatory bowel disease
Michael A Quail1, Richard K Russell, Johan E Van Limbergen
1Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Sick Children, Edinburgh, UK.
Insights
Fecal calprotectin is a highly sensitive marker for diagnosing pediatric inflammatory bowel disease (IBD) in children. This study shows it is more effective than standard blood tests, especially when used together for accurate diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Clinical Diagnostics
- Biomarker Research
Background:
- Inflammatory bowel disease (IBD) diagnosis in children requires sensitive markers.
- Fecal calprotectin is a potential biomarker for gastrointestinal inflammation.
Purpose of the Study:
- To evaluate the diagnostic accuracy of fecal calprotectin in Scottish children with IBD.
- To compare fecal calprotectin with standard blood parameters for IBD diagnosis.
Main Methods:
- Fecal calprotectin was measured in 48 Scottish children at the time of IBD diagnosis.
- Comparative blood test results were analyzed for erythrocyte sedimentation rate, C-reactive protein, platelets, albumin, and hemoglobin.
- Patients included those with Crohn's disease, ulcerative colitis, and unspecified IBD.
Main Results:
- Fecal calprotectin was elevated in 96% of pediatric IBD patients.
- Compared to blood tests, fecal calprotectin showed higher sensitivity in detecting inflammation.
- 7/47 patients had elevated fecal calprotectin without abnormal blood test results.
Conclusions:
- Fecal calprotectin is a more sensitive indicator than common blood tests for diagnosing pediatric IBD.
- Combining fecal calprotectin with blood tests identifies abnormalities in all diagnosed pediatric IBD patients.
- Fecal calprotectin is a valuable addition to routine diagnostic panels for pediatric IBD.
Background:
We aimed to study fecal calprotectin in Scottish children with inflammatory bowel disease (IBD) and compare its diagnostic accuracy with blood parameters.
Methods:
Stool samples from 48 Scottish children (29 males, 19 females) had calprotectin measured at IBD diagnosis. The median age at diagnosis was 11.2 years (interquartile range [IQR] 8.7-13.0 years). There were 33 patients with Crohn's disease, 5 with ulcerative colitis, and 10 with IBD type unspecified. IBD was diagnosed by standard criteria. Calprotectin was measured using a commercially available kit (PhiCal Test) and 47/48 patients had comparative blood results available at diagnosis.
Results:
The fecal calprotectin concentrations were raised in 96% (46/48) of patients studied. The median calprotectin value was 750 microg/g (IQR 235.8-1251 microug/g). In comparison with standard blood tests, 32/45 (71.1%) had abnormal erythrocyte sedimentation rate, 19/38 (50.0%) had abnormal C-reactive protein, 29/46 (63.0%) had raised platelets, 12/45 (26.7%) had hypoalbuminemia, and 38/46 (82.6%) had abnormal hemoglobin. We identified 7/47 (14.9%) patients with raised calprotectin at diagnosis who did not have any abnormalities detected in the blood tests performed. All 48 patients (100%) had at least 1 abnormal blood test and/or raised calprotectin at diagnosis.
Conclusions:
Calprotectin is significantly more likely to be raised than any commonly employed blood tests at IBD diagnosis. When used in combination with these bloods tests an abnormality was demonstrated in 1 or both tests in all patients at diagnosis in this study. Fecal calprotectin measurement is a significant advance when used contemporaneously and in addition to a routine panel of blood tests in the diagnosis of pediatric IBD.
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