Faecal calprotectin concentration in children with coeliac disease

Abstract

Introduction: It is still unknown whether faecal calprotectin elevation may be caused by active untreated coeliac disease (CD) itself or whether it indicates the coexistence of CD and another disease associated with gastrointestinal inflammation. Aim: To assess faecal calprotectin concentration (FCC) and its correlation with the clinical form and histopathological picture of the small intestine in children with CD. Material and methods: Fifty-five children with newly recognised CD (mean age: 9.1 years) and 17 children with CD diagnosed at least year before and on a strict gluten-free diet (mean age: 12.3 years) were accepted for the study. Classical (n = 27), non-classical (n = 17), and asymptomatic form (n = 11) were distinguished in children with newly diagnosed CD based on the clinical picture. The histopathological small intestinal lesions were classified as Marsh 1 (n = 4), 3a (n = 5), 3b (n = 20), and 3c (n = 26). FCC was assessed using ELISA method with 50 µg/g as the upper limit of the normal. Results: FCC was abnormal for 21 patients with newly diagnosed CD (38.2%) and for six patients from the treated group (35.3%). Mean FCC for the analysed group of patients was 91.7 ±144.8 µg/g, in the group with newly diagnosed CD-100.9 ±154.4 µg/g, and in the treated group-61.8 ±106.2 µg/g (Z =-1.333; p = 0.183). In the group of patients with recently diagnosed CD a statistically significant relationship was not observed for FCC and both clinical picture (c 2 = 0.319, p = 0.852) and severity of small intestinal lesions according to the Marsh classification (rho = 0.136). Conclusions: Assessment of FCC seems to have no use as a marker for diagnostics and monitoring of CD irrespective of clinical form of the disease and severity of the inflammatory lesions within the small intestine.

Fecal calprotectin in pediatric gastrointestinal diseases: Pros and cons

“…However, this study was performed in adult patients with late-onset coeliac disease than usually observed in children. Meanwhile, according to the Marsh classification, Szaflarska-Popławska et al [ 108 ] also found no significant relationship between fecal calprotectin and both the clinical picture and small intestinal lesions. In fifty-five children recently diagnosed with coeliac disease.…”

“…While fecal calprotectin values in coeliac disease patients at diagnosis typically average around 100 mg/g across many studies, they significantly increase compared to controls[ 39 ]. However, it's important to note that fecal calprotectin elevation in coeliac disease may not be specific to mucosal inflammation related to gluten exposure[ 108 ]. Other factors, such as concomitant gastrointestinal conditions or dietary habits, could influence fecal calprotectin levels, potentially confounding its interpretation in coeliac disease patients[ 104 ].…”

Celiac Disease: Promising Biomarkers for Follow-Up

“…One year after the introduction of GFD, this had decreased to 4.6 mg/l, which corresponded to the values in healthy controls (4.3 mg/l). In contrast to these results is a study from a Polish team that sought unsuccessfully to find in pediatric patients a correlation between FCP levels, the clinical form of CD (classical, non-classical, and asymptomatic), and histological changes in the small intestine [38]. As no statistically significant relationship was found, those authors did not consider FCP to be a promising marker for diagnosing and monitoring patients with CD.…”

Celiac Disease, Management, and Follow-Up

“…Other markers have been proposed for monitoring GFD, such as the permeability test [113] or fecal calprotectin [114,115]. Determination of fecal calprotectin concentration has established itself in recent years as a new useful marker of gastrointestinal pathologies.…”