Crohnʼs disease activity assessed by fecal calprotectin and lactoferrin: Correlation with Crohnʼs disease activity index and endoscopic findings

Sipponen, Taina; Savilahti, Erkki; Kolho, Kaija‐Leena; Nuutinen, Hannu; Turunen, Ulla; Färkkilä, Martti

doi:10.1002/ibd.20312

Cited by 414 publications

(340 citation statements)

References 43 publications

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“…As endoscopies are also invasive, expensive, and time-consuming with a risk of complications, there is a need for noninvasive screening methods for detecting relapse and postoperative recurrence of CD. Clinical activity indices and serum inflammatory markers correlate poorly with endoscopic disease activity [9,17,18,21]. Fecal calprotectin, which is excreted by migrating neutrophils to the lumen of the inflamed bowel, has been demonstrated a useful surrogate marker for disease activity in both children and adults [18,21,22,31,32].…”

Section: Discussionmentioning

confidence: 99%

“…Clinical activity indices and serum inflammatory markers correlate poorly with endoscopic disease activity [9,17,18,21]. Fecal calprotectin, which is excreted by migrating neutrophils to the lumen of the inflamed bowel, has been demonstrated a useful surrogate marker for disease activity in both children and adults [18,21,22,31,32]. However, FC is not specific to inflammatory bowel disease and may increase in the presence of other gastrointestinal disorders, such as infectious colitis and polyposis [33,34].…”

Section: Discussionmentioning

confidence: 99%

“…Despite resolution of active mucosal inflammation during medical therapy for CD, FC levels may remain elevated reflecting persistent microscopic inflammation of the bowel wall [17,18,21,22,31,32]. Suggested cutoff values for detection of relapse vary between 150 and 275 μg/g, usually with moderate sensitivity but good specificity [17,18,21,32].…”

Section: Discussionmentioning

confidence: 99%

“…Suggested cutoff values for detection of relapse vary between 150 and 275 μg/g, usually with moderate sensitivity but good specificity [17,18,21,32]. Instead, after successful surgery, FC levels should normalize, and consequently the cutoff values for detection of postoperative recurrence are lower [8,25,27,35].…”

Section: Discussionmentioning

confidence: 99%

“…Fecal calprotectin (FC) outperforms serum markers in the detection of bowel wall inflammation and reflects the endoscopic activity of CD reliably in both children and adults [17,18,[20][21][22][23]. Its concentration has been shown to increase in the presence of histological pouch inflammation following proctocolectomy for ulcerative colitis [24].…”

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confidence: 99%

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Fecal calprotectin in the prediction of postoperative recurrence of Crohn's disease in children and adolescents

Hukkinen

Pakarinen

Merras‐Salmio

et al. 2016

Journal of Pediatric Surgery

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a b s t r a c t a r t i c l e i n f oBackground: Fecal calprotectin (FC) correlates with endoscopic recurrence of Crohn's disease (CD) in adults but has not been studied among children postoperatively. We aimed to analyze whether FC relates with postoperative CD recurrence in children. Methods: Altogether 51 postoperative endoscopies and FC measurements from 22 patients having undergone surgery for CD at age ≤18 years were included. Results: Ileocecal resection (n = 15), small bowel resection (n = 6), or left hemicolectomy (n = 1) was performed at median age of 15.1 (interquartile range 14.4-17.6) years. Following surgery, FC decreased significantly (659 vs. 103 μg/g, p = 0.001). During median follow-up of 5.7 (4.2-7.7) years, either endoscopic or histological recurrence occurred in 17 patients (77%). FC N139 μg/g at time of endoscopy or FC increase of 79 μg/g compared to first postoperative value was suggestive of endoscopic recurrence (Rutgeerts score i2-i4), while FC N101 μg/g or increase of 21 μg/g indicated histological recurrence. Best accuracy for prediction of recurrence was obtained by combining FC at endoscopy and the postoperative increase of FC. The corresponding AUROC values were 0.74 (95% 0.58-0.89) for endoscopic recurrence whereas 0.81 (95% CI 0.67-0.95) for histological recurrence. Conclusion: FC is a useful surrogate marker of postoperative recurrence also in pediatric CD patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Fecal calprotectin in the prediction of postoperative recurrence of Crohn's disease in children and adolescents

Hukkinen

Pakarinen

Merras‐Salmio

et al. 2016

Journal of Pediatric Surgery

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Endoscopic scoring indices for evaluation of disease activity in Crohn’s disease

Khanna

Nelson

Feagan

et al. 2016

Cochrane Database of Systematic Reviews

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Endoscopic scoring indices for evaluation of disease activity in Crohn's disease What is Crohn's disease? Crohn's disease is a long-term (chronic) inflammatory bowel disease characterized by pain (abdominal cramping), tiredness, diarrhea and weight loss. When people with Crohn's disease are experiencing symptoms the disease is said to be "active" and when symptoms stop this is called "remission". What is an endoscopic scoring index? An endoscopic scoring index measures disease activity based on what a doctor sees during endoscopy. An endoscopy is a non-surgical procedure used to view the digestive tract using a camera. The doctor who performs the endoscopy can rate disease activity using the index, or this can be done by another o-site doctor if a video of the procedure was recorded. The most commonly used endoscopic scoring indices are the Crohn's Disease Endoscopic Index of Severity (CDEIS) and the Simple Endoscopic Score for Crohn's Disease (SES-CD). What did the researchers investigate? It is important that endoscopic scoring indices are valid, meaning that they accurately measure what they are supposed to measure. The researchers investigated whether studies have assessed the validity of the CDEIS and/or the SES-CD. What did the researchers find? The researchers found that neither the CDEIS nor the SES-CD has been fully validated. Endoscopic scoring indices for evaluation of disease activity in Crohn's disease (Review)

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Crohn's Disease: Clinical Manifestations and Management

Melmed

Targan

2015

Yamada' S Textbook of Gastroenterology

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Crohnʼs disease activity assessed by fecal calprotectin and lactoferrin: Correlation with Crohnʼs disease activity index and endoscopic findings

Abstract: For evaluation of Crohn's disease activity, based on endoscopic findings, more sensitive surrogate markers than is CDAI or CRP are fecal calprotectin and lactoferrin. These prove to be useful tools for estimation of disease activity in Crohn's disease.

Cited by 414 publications

References 43 publications

Fecal calprotectin in the prediction of postoperative recurrence of Crohn's disease in children and adolescents

Fecal calprotectin in the prediction of postoperative recurrence of Crohn's disease in children and adolescents

Endoscopic scoring indices for evaluation of disease activity in Crohn’s disease

Crohn's Disease: Clinical Manifestations and Management

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