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Updated: Aug 30, 2025
Rectal Organoid Morphology Analysis ROMA: A Diagnostic Assay in Cystic Fibrosis
Published on: June 10, 2022
Faecal calprotectin and rectal histological inflammatory markers in cystic fibrosis: a single-centre study
Juliana Roda1,2, Carla Maia3, Susana Almeida3
1Pediatric Gastroenterology and Nutrition Unit, Centro Hospitalar e Universitario de Coimbra EPE Hospital Pediátrico de Coimbra, Coimbra, Portugal juroda@hotmail.com.
Insights
Elevated faecal calprotectin is common in paediatric cystic fibrosis patients, especially with pancreatic insufficiency, and may indicate silent rectal inflammation. This marker is not linked to GI symptoms or malnutrition.
Area of Science:
- Gastroenterology
- Pediatric Pulmonology
- Clinical Biomarkers
Background:
- Cystic Fibrosis (CF) is a genetic disorder affecting multiple organs, including the gastrointestinal tract.
- Faecal calprotectin is a biomarker of intestinal inflammation.
- Understanding faecal calprotectin levels in pediatric CF patients is crucial for monitoring gastrointestinal health.
Purpose of the Study:
- To investigate the association between faecal calprotectin levels and clinical/genetic factors in pediatric patients with cystic fibrosis (PwCF).
- To correlate faecal calprotectin levels with histological inflammatory markers in rectal mucosa biopsies from a subset of PwCF.
Main Methods:
- A prospective study involving 23 pediatric CF patients.
- Collected faecal calprotectin levels, demographic, and clinical data.
- Analyzed rectal biopsies for histological inflammation in 11 patients, correlating findings with faecal calprotectin.
Main Results:
- Seventeen out of 23 PwCF had elevated faecal calprotectin (median 88 µg/g).
- Higher levels were observed in patients with pancreatic insufficiency (p=0.027).
- Faecal calprotectin correlated with histological rectal inflammation (p=0.015), showing 100% sensitivity and 86% specificity.
Conclusions:
- Elevated faecal calprotectin is frequent in pediatric CF patients, particularly those with pancreatic insufficiency.
- Faecal calprotectin levels did not correlate with gastrointestinal symptoms or nutritional status.
- Faecal calprotectin may serve as a valuable indicator of subclinical rectal inflammation in PwCF.
Objective:
To analyse the association of faecal calprotectin with the genetic and clinical characteristics of paediatric patients with cystic fibrosis (PwCF). In a subset of these patients, we aimed to associate histological inflammatory features of rectal mucosa to faecal calprotectin levels.
Methods:
In a prospective study, faecal calprotectin levels were collected in all 23 PwCF attending our paediatric centre, together with demographic and clinical data. Associations between faecal calprotectin and clinical features were determined. In 11 of these patients, endoscopic rectal biopsies were obtained and the association between faecal calprotectin and histological inflammatory markers was analysed. Statistical analyses included Spearman's correlation coefficient, Mann-Whitney U test and Fisher's exact test. Sensitivity and specificity was calculated.
Results:
Median age of PwCF was 12 years, 19 had pancreatic insufficiency (PI) (19/23). Seventeen (17/23) had elevated faecal calprotectin, and the median value was 88 µg/g (IQR=178 µg/g). Higher faecal calprotectin levels were observed in the PI group (101 vs 30 µg/g, p=0.027). No significant correlation between elevated faecal calprotectin level and body mass index z-score was found. Five patients (22%) reported abdominal pain, three (13%) complained of diarrhoea and three (13%) had constipation, but these symptoms were not associated with elevated faecal calprotectin.Unspecific focal rectal inflammation was found in four patients (4/11). An association between rectal mucosa inflammation and elevated faecal calprotectin was found (p=0.015). Sensitivity was 100% and specificity was 86%.
Conclusions:
In our PwCF, elevated faecal calprotectin was frequent, particularly if PI, and it was not related to gastrointestinal symptoms or malnutrition. Elevated faecal calprotectin was present in patients with histological evidence of rectal inflammation. Faecal calprotectin may be an indicator of asymptomatic rectal inflammation in PwCF.
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