Faecal calprotectin as a diagnostic marker of inflammatory bowel disease in patients with gastrointestinal symptoms: meta-analysis

Abstract

Colonoscopy is the standard medical procedure to identify inflammatory bowel disease (IBD) in patients with gastrointestinal symptoms. Noninvasive measurement of faecal calprotectin concentration may replace colonoscopy in this indication. The study aimed to assess efficacy of faecal calprotectin as a diagnostic marker of IBD in patients with symptoms suggestive of such diagnosis. Meta-analysis of diagnostic accuracy studies was performed. Cochrane, EMBASE and MEDLINE databases were searched until December 2018. Inclusion criteria comprised experimental and observational studies, adults with gastrointestinal symptoms, calprotectin as index and colonoscopy as reference test, presence of data on/enabling the calculation of diagnostic accuracy parameters. For each study, sensitivity and specificity of faecal calprotectin were analysed as bivariate data. Nineteen studies were identified. The total number of patients was 5032. Calculated pooled sensitivity and specificity were 0.882 [95% confidence interval (CI), 0.827–0.921] and 0.799 (95% CI, 0.693–0.875), respectively. Following faecal calprotectin incorporation in the diagnostic work-up of 100 people with suspected IBD, 18 non-IBD patients will have a colonoscopy performed and one patient with the disease will not be referred for this examination. Faecal calprotectin concentration measurement is a useful screening test to rule out IBD, at the same time reducing the need for colonoscopy by 66.7%.

Athena: Specialty Certificate Examination case for outpatient medical dermatology

“…Our patient has recently developed bowel symptoms, which potentially could be due to a new presentation of inflammatory bowel disease (IBD), which is known to be associated with HS 2 . A normal faecal calprotectin level excludes intestinal inflammation, and is therefore a useful screening test to exclude IBD 3 . The National Institute for Health and Care Excellence recommends faecal calprotectin testing to guide clinicians when faced with a differential diagnosis of IBD or irritable bowel syndrome in adults with lower gastrointestinal symptoms of recent onset, when bowel cancer is not suspected 4 .…”

“…2 A normal faecal calprotectin level excludes intestinal inflammation, and is therefore a useful screening test to exclude IBD. 3 The National Institute for Health and Care Excellence recommends faecal calprotectin testing to guide clinicians when faced with a differential diagnosis of IBD or irritable bowel syndrome in adults with lower gastrointestinal symptoms of recent onset, when bowel cancer is not suspected. 4 A raised faecal calprotectin level in this particular patient (dermatology patient at high risk of IBD) should trigger a referral to gastroenterology for further investigation.…”

Effect of Enteral Vitamin A on Fecal Calprotectin in Extremely Preterm Infants: A Nested Prospective Observational Study

“…Fecal calprotectin has been studied extensively to diagnose and manage inflammatory bowel disease in adults and children [20,21]. In newborn infants, normal ranges of fecal calprotectin in the term and preterm infants have been reported [13].…”

Elucidating the Role of Innate and Adaptive Immune Responses in the Pathogenesis of Canine Chronic Inflammatory Enteropathy—A Search for Potential Biomarkers

“…Calprotectin, another protein released by activated mononuclear cells, has increased expression in canine intestinal mucosa [56] and is used as a diagnostic and prognostic factor in human IBD [57,58]. Determination of fecal calprotectin concentration is a useful screening test for human IBD diagnosis, reducing the need for colonoscopy by 66.7% [59]. Serum calprotectin concentrations may also be a useful biomarker for the detection of in-flammation in dogs, but the use of certain drugs such as glucocorticoids could limit clinical usefulness [60].…”