Correlation between fecal calprotectin, ulcerative colitis endoscopic index of severity and clinical outcome in patients with acute severe colitis

Abstract

Correlation between fecal calprotectin (FC) and endoscopic activity assessed by Ulcerative Colitis Endoscopic Index of Severity (UCEIS) in acute severe colitis (ASC) patients was explored to evaluate the predictive value of FC in clinical outcomes. Seventy-one ASC patients were retrospectively evaluated. FC level within 3 days of colonoscopy was measured with ELISA. Demographic and clinical data, laboratory parameters, and medical therapy were documented, and the endoscopic severity of disease was rated by UCEIS. The end points were the rate of failed corticosteroid therapy, colectomy, and mortality. There was significant correlation between UCEIS and FC level (r=0.729, P<0.001), which was superior to CRP, ESR, and hemoglobin. FC level between endoscopic mild activity (UCEIS, 3-4) and endoscopic moderate activity (UCEIS, 5-6), and endoscopic moderate activity (UCEIS, 5-6) and endoscopic severe activity (UCEIS, 7-8) were significantly different. FC levels were associated with different outcomes (failed corticosteroid therapy or surgery); when FC >1672 µg/g, sensitivity and specificity were 80.2 and 66.7%, respectively, in prediction for colectomy using receiver operating characteristics analysis. The results indicated that FC, as a non-invasive indicator, correlates positively with the UCEIS. Baseline FC level predicts clinical outcomes in ASC patients, which make a timely treatment strategy conversion possible after accurately forecasting the likelihood of failure of intravenous steroid therapy.

Fecal Calprotectin Is Increased in Stroke

“…Other studies showed that low serum albumin and high CRP levels are associated with severe disease activity in patients with ulcerative colitis [ 21 ]. Furthermore, a correlation was found between fecal calprotectin and clinical outcome in patients with ulcerative colitis [ 22 ]. These findings warrant further study to find the role of FC as a prognostic marker in patients with acute stroke.…”

Development and validation of novel models for the prediction of intravenous corticosteroid resistance in acute severe ulcerative colitis using logistic regression and machine learning

“…Second, endoscopic features and laboratory data are currently routinely involved in the diagnosis and decision-making of clinicians, which could introduce circularity of argument, an inevitable inherent issue in data interpretation, and a prospective study may help in the future [ 27 ]. Moreover, in addition to endoscopic features and laboratory data, many novel predictors for IVCS response in UC patients have been proposed, including fecal calprotectin levels [ 36 , 37 ] and histological indices [ 38–40 ]. These factors were not recorded in our study due to restrictions of objective conditions.…”

Optimal Management of Acute Severe Ulcerative Colitis (ASUC): Challenges and Solutions

“… 13 In another retrospective Chinese cohort of 71 ASUC patients, faecal calprotectin levels >1672 µg/g on day 3 after colonoscopy predicted colectomy with a sensitivity of 80.2% and a specificity of 66.7%. 14 Elevated serum CRP levels at day 3 (>9.9 mg/dL) were also associated with steroid failure in a prospective paediatric cohort of 128 children. 15 Elevated serum procalcitonin levels (>0.10 µg/L) were found to be a predictor for corticosteroid failure and colectomy in a retrospective study of 151 ASUC patients.…”