Skip to main content
Log in

The Assessment of a Rapid Noninvasive Immunochromatographic Assay Test for Fecal Lactoferrin in Patients with Suspected Inflammation of the Ileal Pouch

  • Original Contribution
  • Published:
Diseases of the Colon & Rectum

Abstract

Purpose

Pouchitis is a common complication after ileal pouch-anal anastomosis. Diagnosis is based on the Pouch Disease Activity Index, which comprises clinical symptoms, endoscopic appearance, and histologic confirmation. A Pouch Disease Activity Index ≥ 7 confirms pouchitis. Fecal lactoferrin is a marker of intestinal inflammation, which can aid in the diagnosis of pouchitis. The IBD EZ VUE™ test is a simple, rapid, noninvasive test for fecal lactoferrin. Our goal was to study the sensitivity and specificity of this test in the diagnosis of pouchitis.

Methods

Consecutive patients with pouch dysfunction were recruited from October 2005 to July 2006. A fecal sample was collected before calculation of the Pouch Disease Activity Index. An IBD EZ VUE™ test was performed on each fecal sample and the results correlated with the diagnosis of pouchitis to calculate sensitivity and specificity of the IBD EZ VUE™ test.

Results

There were 32 patients (21 healthy and 11 inflammed pouches). The IBD EZ VUE™ test was positive in 14 patients. It had a sensitivity of 100 percent and a specificity of 86 percent in diagnosing pouchitis. The positive predictive value was 76 percent. There were three false-positive results.

Conclusions

The IBD EZ VUE™ test is a sensitive method that may remove the need for invasive pouch investigations and lead to greater confidence when antibiotic therapy is commenced. Further investigations may be reserved for those patients who have a positive lactoferrin test and fail to respond to antibiotic treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Mikkola K, Luukkonen P, Jarvinen H. Long-term results of restorative proctocolectomy for ulcerative colitis. Int J Colorectal Dis 1994;10:10–4.

    Google Scholar 

  2. Utsonomiya J, Iwama T, Imajo M, et al. Total colectomy, mucosal proctectomy and ileoanal anastomosis. Dis Colon Rectum 1980;23:459–66.

    Article  Google Scholar 

  3. Abdelrazeq A, Lund J, Leveson S. Implications of pouchitis on the functional results following stapled restorative proctocolectomy. Dis Colon Rectum 2005;48:1700–7.

    Article  PubMed  Google Scholar 

  4. Karlbom U, Raab Y, Ejerblad S, et al. Factors influencing the functional outcome of restorative proctocolectomy in ulcerative colitis. Br J Surg 2000;87:1401–8.

    Article  PubMed  CAS  Google Scholar 

  5. Shen B, Achkar J, Lashner B, et al. Endoscopic and histologic evaluation together with symptom assessment are required to diagnose pouchitis. Gastroenterology 2001;121:261–7.

    Article  PubMed  CAS  Google Scholar 

  6. Rado T, Bollekens J, St. Laurent G, et al. Lactoferrin biosynthesis during granulocytopoeisis. Blood 1984;64: 1103–9.

    PubMed  CAS  Google Scholar 

  7. Guerrant R, Araujo V, Soares E, et al. Measurement of fecal lactoferrin as a marker of fecal leukocytes. J Clin Microbiol 1992;30:1238–42.

    PubMed  CAS  Google Scholar 

  8. D'Inca R, Dal Pont E, Di Leo V, et al. Calprotectin and lactoferrin in the assessment of intestinal inflammation and organic disease. Int J Colorectal Dis 2006;22:429–37

    Article  PubMed  Google Scholar 

  9. Kane S, Sandborn W, Rufo P, et al. Fecal lactoferrin is a sensitive and specific marker in identifying intestinal inflammation. Am J Gastroenterol 2003;98:1309–14.

    Article  PubMed  CAS  Google Scholar 

  10. Parsi M, Shen B, Achkar J, et al. Fecal lactoferrin for diagnosis of symptomatic patients with ileal pouch-anal anastomosis. Gastroenterology 2004;126:1280–6.

    Article  PubMed  Google Scholar 

  11. Sandborn W, Tremaine W, Batts K, et al. Pouchitis after ileal pouch-anal anastomosis: a pouchitis activity index. Mayo Clin Proc 1994;69:409–15.

    PubMed  CAS  Google Scholar 

  12. Whitlock D, Sigmon S, Boone J. Assessing intestinal inflammation using a new rapid in vitro assay that detects lactoferrin. American College of Gastroenterology Meeting (abstract). Nevada, 2006.

  13. Shen B, Fazio V, Remzi F, et al. Comprehensive evaluation of inflammatory and non-inflammatory sequelae of ileal pouch-anal anastomoses. Am J Gastroenterol 2005;100:93–101.

    Article  PubMed  Google Scholar 

  14. Lim M, Sagar P, Abdulgader A, Thekkinkattil D, Burke D. The impact of preoperative immunomodulation on pouch related septic complications after ileal pouch-anal anastomosis (IPAA). Dis Colon Rectum 2007;50:943–51.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Dermot Burke F.R.C.S..

Additional information

IBD EZ VUE™ fecal lactoferrin kit was supplied by TECHLAB® Inc., Blacksburg, Virginia, via ScheBo® Biotech UK Limited, Basingstoke, United Kingdom.

Read at the meeting of The American Society of Colon and Rectal Surgeons, St. Louis, Missouri, June 2 to 7, 2007.

Reprints are not available.

About this article

Cite this article

Lim, M., Gonsalves, S., Thekkinkattil, D. et al. The Assessment of a Rapid Noninvasive Immunochromatographic Assay Test for Fecal Lactoferrin in Patients with Suspected Inflammation of the Ileal Pouch. Dis Colon Rectum 51, 96–99 (2008). https://doi.org/10.1007/s10350-007-9151-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10350-007-9151-x

Key words

Navigation