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Juvenile Polyps in Bangladeshi Children and Their Association with Fecal Calprotectin as a Biomarker
Subarna Rani Das1, A S M Bazlul Karim1, Md RukonUzzaman1
1Department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Insights
Fecal calprotectin (FCP) is elevated in children with juvenile polyps and normalizes after polyp removal. This suggests FCP can serve as a noninvasive screening biomarker for juvenile polyps, reducing the need for colonoscopy.
Area of Science:
- Pediatric Gastroenterology
- Biomarker Discovery
- Gastrointestinal Diseases
Background:
- Colonoscopy is the gold standard for diagnosing juvenile polyps but is invasive and costly.
- Fecal calprotectin (FCP), an inflammation marker, is elevated in patients with polyps.
- There is a need for noninvasive diagnostic methods for juvenile polyps.
Purpose of the Study:
- To evaluate fecal calprotectin (FCP) as a screening biomarker for juvenile polyps.
- To compare FCP levels in children with and without juvenile polyps.
- To assess changes in FCP levels after polyp removal.
Main Methods:
- A cross-sectional, observational study was conducted in Dhaka, Bangladesh.
- Children underwent colonoscopy, polypectomy, and histopathology.
- Fecal calprotectin levels were measured before and 4 weeks after polypectomy.
Main Results:
- Children with juvenile polyps showed significantly elevated FCP levels before polypectomy (mean 277±247 µg/g) compared to after normalization (mean 48.57±38.23 µg/g).
- FCP levels were higher in patients with multiple polyps (515.4±320.5 µg/g) than single polyps (207.6±172.4 µg/g).
- Most polyps (93%) were located in the rectosigmoid region in children aged 2.5-12 years.
Conclusions:
- Elevated FCP levels are associated with colonic juvenile polyps.
- FCP levels normalize after polypectomy, supporting its role as a transient biomarker.
- Fecal calprotectin shows promise as a noninvasive screening tool for juvenile polyps.
Purpose:
Colonoscopy is considered the most reliable method for the diagnosis of juvenile polyps. However, colonoscopic screening is an invasive and expensive procedure. Fecal calprotectin (FCP), a marker of intestinal inflammation, has been shown to be elevated in patients with polyps. Therefore, this study aimed to evaluate FCP as a screening biomarker for the diagnosis of juvenile polyps.
Methods:
This cross-sectional, observational study was conducted at the Pediatric Gastroenterology and Nutrition Department, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. For children with polyps, colonoscopic polypectomy and histopathology were performed. FCP levels were analyzed before and 4 weeks after polypectomy in all patients. Information was recorded in a datasheet and analyzed using the computer-based program SPSS.
Results:
The age of the children was between 2.5 and 12 years. Approximately 93% of the polyps were found in the rectosigmoid region. Children with juvenile polyps had elevated levels of FCP before polypectomy that subsequently normalized after polypectomy. The mean FCP levels before and after polypectomy were 277±247 µg/g (range, 80-1,000 µg/g) and 48.57±38.23 µg/g (range, 29-140 µg/g) (p<0.001), respectively. The FCP levels were significantly higher in patients with multiple polyps than in those with single polyps. Moreover, mean FCP levels in patients with single and multiple polyps were 207.6±172.4 µg/ g and 515.4±320.5 µg/g (p<0.001), respectively.
Conclusion:
Colonic juvenile polyps were found to be associated with elevated levels of FCP that normalized after polypectomy. Therefore, FCP may be recommended as a noninvasive screening biomarker for diagnosis of colonic juvenile polyps.
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