Original Article

Digestive Diseases and Sciences

, Volume 56, Issue 8, pp 2372-2377

Fecal Calprotectin Is a Useful Marker for Disease Activity in Pediatric Patients with Inflammatory Bowel Disease

  • Tomoki AomatsuAffiliated withDepartment of Pediatrics, Osaka Medical College
  • , Atsushi YodenAffiliated withDepartment of Pediatrics, Osaka Medical College Email author 
  • , Kyoichi MatsumotoAffiliated withMikuri Immunological Lab. Co
  • , Emi KimuraAffiliated withMikuri Immunological Lab. Co
  • , Keisuke InoueAffiliated withDepartment of Pediatrics, Osaka Medical College
  • , Akira AndohAffiliated withDivision of Mucosal Immunology, Graduate School of Medicine, Shiga University of Medical Science
  • , Hiroshi TamaiAffiliated withDepartment of Pediatrics, Osaka Medical College

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Abstract

Background

Studies evaluating the correlation between endoscopic disease activity and noninvasive markers are scarce in inflammatory bowel disease (IBD).

Aim

The aim of this study is to evaluate the accuracy of the fecal calprotectin (FC) assay as a marker of disease activity of IBD, as determined by an extensive endoscopic scoring system.

Methods

Thirty-five children and adolescents with IBD [17 with ulcerative colitis (UC) and 18 with Crohn’s disease (CD)] and 28 healthy volunteers were enrolled. FC levels were determined by ELISA. The sum of Matts’ score for UC and the simple endoscopic score for Crohn’s disease (SES-CD) were used. The ileal lesions were evaluated by ultrasonography.

Results

In UC patients, there was a strong correlation between FC levels and the sum of Matts’ score (r = 0.838, p < 0.01). FC levels were significantly elevated in endoscopically active patients (median 1,562.5 μg/g) as compared to patients in endoscopic remission (median 38.9 μg/g) or healthy controls (median 19.9 μg/g). In CD patients, there was a strong correlation between FC levels and the SES-CD score (r = 0.760, p < 0.01). The FC levels were significantly higher in endoscopically active patients (median 2,037.5 μg/g) than in endoscopically inactive patients (median 172.5 μg/g) or healthy controls (median 19.9 μg/g), respectively. The FC levels of patients with ileal wall thickening (median 2,225.0 μg/g) were significantly higher than healthy controls (median 19.9 μg/g) and patients lacking ileal wall thickening (median 17.5 μg/g), respectively.

Conclusions

The FC assay is a useful marker for the detection of mucosal inflammation in pediatric IBD patients.

Keywords

Fecal calprotectin Inflammatory bowel disease Children Mucosal healing Biomarker