Related Experiment Video
Updated: Jun 27, 2025
Diagnosis of Hirschsprung's Disease by Immunostaining Rectal Suction Biopsies for Calretinin, S100 Protein and Protein Gene Product 9.5
Published on: April 26, 2019
Exploring the Diagnostic Spectrum of Children with Raised Faecal Calprotectin Levels
Angharad Vernon-Roberts1, Olivia Humphrey2, Andrew S Day1
1Department of Paediatrics, University of Otago Christchurch, Christchurch 8011, New Zealand.
Insights
Raised fecal calprotectin (FC) in children without inflammatory bowel disease (IBD) often indicates mild inflammation or infection. Repeat FC testing can help differentiate diagnoses, guiding further investigation and management.
Area of Science:
- Pediatric Gastroenterology
- Clinical Diagnostics
- Inflammatory Bowel Disease Research
Background:
- Faecal calprotectin (FC) is a key biomarker for intestinal inflammation.
- Limited research exists on the significance of elevated FC in children without established inflammatory bowel disease (IBD).
Purpose of the Study:
- To investigate the causes and clinical relevance of abnormal FC levels in children aged 4-17 years without diagnosed IBD.
- To stratify abnormal FC results and analyze associated symptoms and diagnostic findings.
Main Methods:
- Retrospective study of children with abnormal FC tests in South Island, New Zealand.
- Stratification of FC results into ranges (51-249, 250-499, 500+ μg/g).
- Collection of data on symptoms, diagnostic tests, and follow-up diagnoses.
Main Results:
- 310 children had abnormal FC; median age 12.9 years, 55% female.
- Most abnormal FC levels (71%) were in the mild range (51-249 μg/g).
- Children with FC 500+ μg/g were frequently diagnosed with infectious diarrhea or IBD; alarm symptoms were not differentiating.
Conclusions:
- Elevated FC in children without IBD often reflects mild inflammation or infection, with levels below the typical threshold for significant mucosal inflammation.
- Abnormalities in platelet counts, ultrasound, and colonoscopy were more common in children diagnosed with IBD.
- Repeat FC testing is valuable for distinguishing diagnoses, especially in differentiating IBD from other causes of elevated FC.
Abstract:
Faecal calprotectin (FC) is a marker of gut inflammation. The cause and relevance of raised FC in children outside the context of established inflammatory bowel disease (IBD) have had minimal attention. This study aimed to address this by carrying out a retrospective study on children with abnormal FC tests aged 4-17 years without established IBD in the South Island, New Zealand. Abnormal FC results were stratified: 51-249 μg/g, 250-499 μg/g, and 500+ μg/g, and participants were categorised into diagnostic groups. Data were collected on symptoms and diagnostic tests. Three-hundred and ten children had abnormal index FC results, with a mean age of 12.9 years, and a 55% proportion of females. The median FC was 125 μg/g; 71% had levels 51-249 μg/g and 21% had levels 500+ μg/g. Of those with FC 500+ μg/g, 89% either had infectious diarrhoea or were diagnosed with IBD at the time of, or subsequent to, the index FC. Alarm symptoms did not delineate between groups with FC 500+ μg/g. Abnormalities in platelet levels, abdominal ultrasound, and colonoscopy were more frequent for children diagnosed with IBD. Repeat FC test levels were significantly reduced except for those subsequently diagnosed with IBD. Abnormal FC levels for the majority were below the level indicative of mucosal inflammation. Repeat FC testing could play an important role in distinguishing between diagnoses.
Related Concept Videos
01:30Serum Laboratory Studies, Stool Test, Breath Test
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:25Assessment of the Rectum and Anus
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.