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Selecting children with suspected inflammatory bowel disease for endoscopy with the calgranulin C or calprotectin
Anke Heida1, Els Van de Vijver2, Anneke Muller Kobold3
1Department of Pediatric Gastroenterology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Insights
Faecal calgranulin C (S100A12) shows promise in diagnosing pediatric inflammatory bowel disease (IBD) more accurately than faecal calprotectin (FC). This study compares their effectiveness in children with gastrointestinal issues.
Area of Science:
- Gastroenterology
- Pediatric Medicine
- Biomarker Research
Background:
- Faecal calprotectin (FC) aids in diagnosing pediatric inflammatory bowel disease (IBD) but often leads to unnecessary endoscopies.
- Faecal calgranulin C (S100A12), a marker exclusively from activated granulocytes, may offer higher specificity for IBD.
Purpose of the Study:
- To compare the diagnostic specificity and sensitivity of S100A12 against FC in children with suspected IBD.
- To determine if S100A12 can improve diagnostic accuracy and reduce unnecessary invasive procedures.
Main Methods:
- An international prospective cohort of children with suspected IBD was enrolled.
- Patients were screened using both FC and S100A12 stool tests.
- Diagnostic accuracy was assessed against reference standards (endoscopy and clinical follow-up).
Main Results:
- The study aims to calculate and compare the specificity and sensitivity of S100A12 and FC.
- Differences in diagnostic performance between the two markers will be quantified.
Conclusions:
- S100A12 may be a more specific biomarker for pediatric IBD than FC.
- This research could refine diagnostic pathways, potentially reducing invasive procedures for children with gastrointestinal complaints.
Introduction:
The introduction of the faecal calprotectin (FC) test to screen children with chronic gastrointestinal complaints has helped the clinician to decide whether or not to subject the patient to endoscopy. In spite of this, a considerable number of patients without inflammatory bowel disease (IBD) is still scoped. Faecal calgranulin C (S100A12) is a marker of intestinal inflammation that is potentially more specific for IBD than FC, as it is exclusively released by activated granulocytes.
Objective:
To determine whether the specificity of S100A12 is superior to the specificity of FC without sacrificing sensitivity in patients with suspected IBD.
Methods:
An international prospective cohort of children with suspected IBD will be screened with the existing FC stool test and the new S100A12 stool test. The reference standard (endoscopy with biopsies) will be applied to patients at high risk of IBD, while a secondary reference (clinical follow-up) will be applied to those at low risk of IBD. The differences in specificity and sensitivity between the two markers will be calculated.
Ethics And Dissemination:
This study is submitted to and approved by the Medical Ethics Review Committee of the University Medical Center Groningen (the Netherlands) and the Antwerp University Hospital (Belgium). The results will be disseminated through a peer-reviewed publication, conference presentation and incorporation in the upcoming National Guideline on Diagnosis and Therapy of IBD in Children.
Trial Registration:
ClinicalTrials.gov identifier: NCT02197780 .
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