Association Between Fecal Calprotectin Levels and Small-bowel Inflammation Score in Capsule Endoscopy: A Multicenter Retrospective Study

Koulaouzidis, Anastasios; Sipponen, Taina; Németh, Artúr; Makins, Richard; Kopylov, Uri; Nadler, Moshe; Giannakou, Andry; Yung, Diana E; Johansson, Gabriele Wurm; Bartzis, Leonidas; Thorlacius, Henrik; Seidman, Ernest G.; Eliakim, Rami; Plevris, John; Tóth, Ervin

doi:10.1007/s10620-016-4104-7

Cited by 26 publications

(21 citation statements)

References 35 publications

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“…If physicians can ignore small lesions to consider the long-term outcome of CD, abdominal ultrasonography and magnetic resonance enterography (MRE) will also be excellent modalities to evaluate MH. Koulaouzidis et al reported that the LS appears to have only a fair correlation with the FC level, as well as other serological markers of inflammation [ 33 ]. FC level does not seem to be a reliable biomarker for significant SB inflammation.…”

Section: Discussionmentioning

confidence: 99%

Validity of Capsule Endoscopy in Monitoring Therapeutic Interventions in Patients with Crohn’s Disease

Nakamura

Yamamura

Maeda

et al. 2018

JCM

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Mucosal healing in Crohn’s disease (CD) can be evaluated by capsule endoscopy (CE). However, only a few studies have utilized CE to demonstrate the therapeutic effect of medical treatment. We sought to evaluate the validity of using CE to monitor the effect of medical treatment in patients with CD. One hundred (n = 100) patients with CD were enrolled. All patients had a gastrointestinal (GI) tract patency check prior to CE. Patients with baseline CE Lewis score (LS) ≤ 135 were included in the non-active CD group and ended the study. In those with LS > 135 (active CD group), additional treatment was administered, regardless of symptoms, as per the treating clinician’s advice. Patients of the active CD group underwent follow-up CE assessment 6 months later. Out of 92 patients with confirmed GI patency who underwent CE, 40 (43.4%) had CE findings of active inflammation. Of 29 patients with LS > 135 who received additional medications and underwent follow-up CE, improvement of the LS was noted in 23 (79.3%) patients. Eleven patients were asymptomatic but received additional medications; 8 (72.7%) had improvement of the LS. This study demonstrated that additional treatment even for patients with CD in clinical remission and active small-bowel inflammation on CE can reduce mucosal damage.

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Section: Discussionmentioning

confidence: 99%

Validity of Capsule Endoscopy in Monitoring Therapeutic Interventions in Patients with Crohn’s Disease

Nakamura

Yamamura

Maeda

et al. 2018

JCM

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“…Two additional studies published since also provided evidence in support of this notion [ 25 , 26 ]. On the other hand, some studies have shown that the correlation between FCP and objective assessment of the SB inflammation such as the validated LS is equivocal or moderate at best [ 27 , 28 ]. This may have been influenced by the retrospective nature of these studies or inherently within the LS itself, as the presence of a stricture without an associated inflammation will significantly increase the score but may not be associated with a corresponding increase in FCP.…”

Section: Discussionmentioning

confidence: 99%

Unsuspected Small-Bowel Crohn’s Disease in Elderly Patients Diagnosed by Video Capsule Endoscopy

Chen

Duchatellier

Seidman

2018

Diagnostic and Therapeutic Endoscopy

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Background Video capsule endoscopy (VCE) is increasingly performed among the elderly for obscure bleeding. Our aim was to report on the utility of VCE to uncover unsuspected Crohn's disease (CD) in elderly patients. Methods Retrospective review of VCE performed in elderly patients (≥70 y) at a tertiary hospital (2010–2015). All underwent prior negative bidirectional endoscopies. CD diagnosis was based on consistent endoscopic findings, exclusion of other causes, and a Lewis endoscopic score (LS) > 790 (moderate-to-severe inflammation). Those with lower LS (350–790) required histological confirmation. Known IBD cases were excluded. Results 197 VCE were performed (mean age 78; range 70–93). Main indications were iron deficiency anemia (IDA), occult GI bleeding (OGIB), chronic abdominal pain, or diarrhea. Eight (4.1%) were diagnosed as CD based on the aforementioned criteria. Fecal calprotectin (FCP) was elevated in 7/8 (mean 580 μg/g). Mean LS was 1824. Small-bowel CD detected by VCE led to a change in management in 4/8. One patient had capsule retention secondary to NSAID induced stricture, requiring surgical retrieval. Conclusions VCE can be safely performed in the elderly. A proportion of cases may have unsuspected small-bowel CD despite negative endoscopies. FCP was the best screening test. Diagnosis frequently changed management.

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“…With a limited number of observations, this finding should be interpreted carefully, especially because patients with L1 tended to have a relatively mild disease. Nevertheless, proximal CD detection by measuring SC is problematic, and parallel quantification of calprotectin and EDN may reduce risk of false‐negative results. We combined calprotectin and EDN measurements in the CALEDN test, and this modification resulted in increasing both AUC and sensitivity values.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory bowel disease detection and monitoring by measuring biomarkers in non‐invasively collected colorectal mucus

Loktionov

Chhaya

Bandaletova

et al. 2017

J of Gastro and Hepatol

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Association Between Fecal Calprotectin Levels and Small-bowel Inflammation Score in Capsule Endoscopy: A Multicenter Retrospective Study

Cited by 26 publications

References 35 publications

Validity of Capsule Endoscopy in Monitoring Therapeutic Interventions in Patients with Crohn’s Disease

Validity of Capsule Endoscopy in Monitoring Therapeutic Interventions in Patients with Crohn’s Disease

Unsuspected Small-Bowel Crohn’s Disease in Elderly Patients Diagnosed by Video Capsule Endoscopy

Inflammatory bowel disease detection and monitoring by measuring biomarkers in non‐invasively collected colorectal mucus

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