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Fecal calprotectin in healthy children
1University of Århus , Århus.
Insights
New fecal calprotectin (FC) cut-off levels for children under four are established. These values aid in diagnosing inflammatory bowel disease (IBD) in infants and toddlers without invasive procedures.
Area of Science:
- Gastroenterology
- Pediatric Medicine
- Clinical Diagnostics
Background:
- Fecal calprotectin (FC) is a reliable marker for bowel inflammation and inflammatory bowel disease (IBD).
- Established FC cut-off levels exist for adults and children over four years old.
- Children under four generally exhibit higher FC levels, necessitating age-specific diagnostic thresholds.
Purpose of the Study:
- To determine normal fecal calprotectin values in healthy children aged 0-4 years.
- To establish new, age-specific cut-off levels for FC in this pediatric demographic.
- To facilitate accurate IBD diagnosis in young children using non-invasive methods.
Main Methods:
- Analysis of 75 stool samples from healthy children aged 0-4 years.
- Comparison with 157 pediatric cases requiring FC analysis for diagnostic purposes.
- Calculation of FC cut-off levels based on the 97.5th percentile for distinct age subgroups.
Main Results:
- Established three new FC cut-off levels for children under four: 538 mg/kg (1-6 months), 214 mg/kg (6 months-3 years), and 75 mg/kg (3-4 years).
- These levels reflect age-related variations in FC concentrations.
- The findings support the use of FC as a non-invasive diagnostic tool in young children.
Conclusions:
- New fecal calprotectin cut-off levels are proposed for children aged 0-4 years.
- These age-specific thresholds improve the diagnostic accuracy of inflammatory bowel disease in infants and toddlers.
- The study supports non-invasive fecal calprotectin testing for pediatric gastrointestinal inflammation.
Abstract:
Calprotectin is a protein found in the cytosol of inflammatory cells and is a marker of the presence and the degree of inflammation in the bowel system. Calprotectin in feces has great diagnostic value in the matter of inflammatory bowel disease (IBD). In feces, the protein is stable up to seven days, and since the protein can easily be measured with an ELISA, the use of fecal calprotectin (FC) means no invasive measures. For adults and children over 4 years, a cut-off level of 50 mg/kg has been well established for diagnostic purposes. Because previous studies have proven that children under the age of four in general have higher FC values than older children and adults, there is a need for a cut-off level for this age group. In order to establish that, the normal values for FC in children from 0-4 years were investigated. Some 75 stool samples from healthy children were collected and the levels of FC were analyzed. The results were compared to 157 pediatric cases where FC analysis had been performed for diagnostic purposes. As a result, three cut-off levels were established based on the 97.5% percentiles of FC in different age groups: 538 mg/kg (1 < 6 months), 214 mg/kg (6 months < 3 years) and 75 mg/kg (3 < 4 years).
