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Fecal calprotectin in the pediatric population: a 2020 update
Fabio CisarÒ1, Antonio Pizzol2, Caterina Rigazio2
1Unit of Pediatric Gastroenterology, Department of Pediatrics, Città della Salute e della Scienza, Turin, Italy - fcisaro@cittadellasalute.to.it.
Insights
Fecal calprotectin (FC) is a valuable marker for intestinal inflammation, aiding in differentiating organic from non-organic gastrointestinal diseases in children. This review highlights FC
Area of Science:
- Biochemistry
- Gastroenterology
- Pediatrics
Background:
- Calprotectin, a calcium and zinc-binding protein complex (S100A8/S100A9), is released by neutrophils.
- Extracellular calprotectin in feces correlates with intestinal inflammation and neutrophil activity.
- Fecal calprotectin (FC) aids in distinguishing organic from non-organic gastrointestinal disorders.
Purpose of the Study:
- To review current evidence on the utility of fecal calprotectin in pediatric gastrointestinal disorders.
- To discuss established indications and future prospects for FC testing in children.
- To emphasize FC's role in primary care for managing pediatric GI symptoms.
Main Methods:
- Literature review of studies on fecal calprotectin in children.
- Analysis of current evidence regarding FC's diagnostic and management applications.
- Discussion of FC's role in differentiating organic vs. non-organic GI diseases.
Main Results:
- Increased FC levels are observed in various pediatric conditions including gastroenteritis, microscopic colitis, polyps, malignancies, and cystic fibrosis.
- FC testing can reduce the need for invasive procedures like colonoscopy by identifying inflammatory origins of GI symptoms.
- Evidence supports FC's utility in managing pediatric GI disorders, though clear guidelines are still developing.
Conclusions:
- Fecal calprotectin is a significant non-invasive biomarker for pediatric intestinal inflammation.
- Incorporating FC into primary care can improve diagnostic accuracy and streamline investigations for GI issues in children.
- Further research and guideline development are needed to optimize FC's application in pediatric gastroenterology.
Abstract:
Calprotectin is a calcium and zinc-binding protein, formed by a hetero complex of S100A8 and S100A9 proteins, which belong to the S-100 protein family consisting in more than 20 different proteins with a tissue-specific expression pattern. This protein is secreted extracellularly from stimulated neutrophils or released by cell disruption or death. The presence of calprotectin in feces quantitatively relates to neutrophil migration toward the gastrointestinal (GI) tract; thus, it represents a useful marker of intestinal inflammation. Fecal calprotectin (FC) has been proven largely useful for determining the inflammatory origin of GI symptoms differentiating between organic and non-organic diseases. Indeed, increased FC levels are also seen in gastroenteritis, microscopic colitis, polyps, malignancies and cystic fibrosis. To date, there are many evidences regarding usefulness in the detection of fecal calprotectin for the management of gastrointestinal disorders, both in children and adults but, especially in the pediatric population, still clear indications for its use are lacking. Its incorporation in primary care reduces the risk of missing an organic disease and facilitates the indication for expensive and invasive investigations as colonoscopy. We herein review and discuss the last evidence on the usefulness of FC in children, with its current indications and future prospective.
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