Fecal calprotectin levels in pediatric cow's milk protein allergy

Lendvai-Emmert, Dominika; Emmert, Vanessza; Makai, Alexandra; Fusz, Katalin; Prémusz, Viktória; Eklics, Kata; Patrícia, Silvia; Tóth, Peter P.; Amrein, Krisztina; Tóth, Gergely

doi:10.3389/fped.2022.945212

Cited by 4 publications

(2 citation statements)

References 26 publications

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“…Therefore, the definitive diagnosis relies on eliminating milk from the diet to observe symptom resolution and assess for relapse upon milk reintroduction[ 74 ]. In infants and children with CMPA, increased levels of fecal calprotectin indicate underlying intestinal inflammation, likely caused by the immune system's response to cow milk proteins[ 75 ]. Studies have shown that infants with CMPA, particularly those with non-IgE-mediated disease, tend to have higher fecal calprotectin concentrations than healthy controls[ 76 ].…”

Section: Discussionmentioning

confidence: 99%

Fecal calprotectin in pediatric gastrointestinal diseases: Pros and cons

Al-Beltagi,

Saeed,

Bediwy

et al. 2024

World J Clin Pediatr

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BACKGROUND Fecal calprotectin is a valuable biomarker for assessing intestinal inflammation in pediatric gastrointestinal diseases. However, its role, pros, and cons in various conditions must be comprehensively elucidated. AIM To explore the role of fecal calprotectin in pediatric gastrointestinal diseases, including its advantages and limitations. METHODS A comprehensive search was conducted on PubMed, PubMed Central, Google Scholar, and other scientific research engines until February 24, 2024. The review included 88 research articles, 56 review articles, six meta-analyses, two systematic reviews, two consensus papers, and two letters to the editors. RESULTS Fecal calprotectin is a non-invasive marker for detecting intestinal inflammation and monitoring disease activity in pediatric conditions such as functional gastrointestinal disorders, inflammatory bowel disease, coeliac disease, coronavirus disease 2019-induced gastrointestinal disorders, gastroenteritis, and cystic fibrosis-associated intestinal pathology. However, its lack of specificity and susceptibility to various confounding factors pose challenges in interpretation. Despite these limitations, fecal calprotectin offers significant advantages in diagnosing, monitoring, and managing pediatric gastrointestinal diseases. CONCLUSION Fecal calprotectin holds promise as a valuable tool in pediatric gastroenterology, offering insights into disease activity, treatment response, and prognosis. Standardized protocols and guidelines are needed to optimize its clinical utility and mitigate interpretation challenges. Further research is warranted to address the identified limitations and enhance our understanding of fecal calprotectin in pediatric gastrointestinal diseases.

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Section: Discussionmentioning

confidence: 99%

Fecal calprotectin in pediatric gastrointestinal diseases: Pros and cons

Al-Beltagi,

Saeed,

Bediwy

et al. 2024

World J Clin Pediatr

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“…Moreover, a decrease in FCP values after the elimination of the trigger food(s) from the diet was noted [ 10 , 33 , 34 ]. In addition, some recent studies have shown the putative diagnostic and predictive therapy-response role of FCP in children with CMPA [ 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Fecal Calprotectin in Self-Reported Milk Intolerance: Not Only Lactose Intolerance

et al. 2023

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The hypothesis is that inflammatory/allergic conditions should be considered in self-reported milk intolerance (SRMI) patients who test negative and/or are asymptomatic at Lactose Hydrogen Breath Test (LHBT). We analyzed fecal calprotectin (FCP) values in SRMI patients to investigate the frequency of a “positive” intestinal inflammation marker and its correlation with lactose tolerance/intolerance. Data from 329 SRMI patients were retrospectively analyzed; according to the positive/negative results (maldigester/digester) and the presence/absence of symptoms reported during LHBT (intolerant/tolerant), patients were divided into: ‘lactose tolerants’ (n. 104), ‘maldigesters/intolerants’ (n. 187), ‘digesters/intolerants’ (n. 38). FCP values were analyzed in all three subgroups. A percentage of SRMI patients complained of constipation (>15%), extraintestinal symptoms (>30% including anemia), multiple food hypersensitivity (7.6%) and had intraepithelial lymphocytic infiltration at duodenal biopsy (>50%). Over 50.0% showed FCP values above the normal limit. Lactose tolerants and maldigesters/intolerants had higher positivity frequencies (p < 0.0001, for both) and absolute values (p = 0.04, for maldigesters/intolerants) of FCP compared to digesters/intolerants. FCP was not useful to differentiate tolerant from intolerant subjects (AUC 0.58). Our data suggest the existence of an allergic/inflammatory pathogenetic mechanism in a subset of SRMI subjects. FCP results are in keeping with this hypothesis, even if they cannot differentiate lactose tolerant from intolerant patients.

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Difficulties in diagnosing non-IgE-dependent gastrointestinal forms of food allergy: How informative is fecal calprotectin?

Zakharova,

Berezhnaya,

Dmitrieva

et al. 2024

Medicinskij sovet

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The prevalence of allergic diseases is increasing at rates corresponding to epidemic’s spread rates. Cow’s milk protein allergy (CMPA) is one of the most common food allergies in infancy. Its clinical variants remain hard-to-diagnose diseases due to their multiple clinical faces. Food allergy can develop along the pathway associated with both IgE and non-IgE, or mixed one. Non-IgEassociated variants of food allergies, due to the lack of accurate and specific laboratory markers, can cause significant difficulties in making a diagnosis. The search for new diagnostic markers continues. Faecal calprotectin, a calcium-binding leukocyte protein consisting of a complex of two monomers S100A8 and S100A9, may be one of them. Faecal calprotectin concentration is directly proportional to the number of leukocytes migrating into the intestinal wall, due to which faecal calprotectin becomes an accurate, non-invasive and sensitive indicator reflecting the level of inflammation in the intestines. Today, serum and faecal calprotectin are used as laboratory markers, and the latter, being more accessible and not critical for collection material is widely known as a diagnostic marker of inflammatory bowel diseases. Some studies suggest that faecal calprotectin may be used to diagnose cow’s milk protein allergy in young infants when other diagnostic tests are not available. Data from various studies remain contradictory. Further studies to investigate the possibilities of using faecal calprotectin as a marker of the gastrointestinal food allergy in young children is needed.

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Fecal calprotectin levels in pediatric cow's milk protein allergy

Cited by 4 publications

References 26 publications

Fecal calprotectin in pediatric gastrointestinal diseases: Pros and cons

Fecal calprotectin in pediatric gastrointestinal diseases: Pros and cons

Fecal Calprotectin in Self-Reported Milk Intolerance: Not Only Lactose Intolerance

Difficulties in diagnosing non-IgE-dependent gastrointestinal forms of food allergy: How informative is fecal calprotectin?

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