Abstract
Background
An accurate monitoring of mucosal inflammation is important for an effective management
of patients with inflammatory bowel disease. Intestinal inflammation can be detected
by faecal calprotectin level determination.
Aim
To comparatively evaluate the accuracy of faecal calprotectin, clinical scores, common
serum markers and endoscopy in the assessment of the severity of intestinal mucosa
inflammation in children with inflammatory bowel disease.
Methods
Fifty-eight paediatric patients (mean age 13.9 years, 95% CI 2.9–14.8; male 28) with
confirmed inflammatory bowel disease (26 Crohn's disease, 32 ulcerative colitis) were
enrolled. Before endoscopy, all patients underwent a complete evaluation including:
clinical scores, erythrocyte sedimentation rate, C-reactive protein and faecal calprotectin
determination. The severity of mucosal inflammation was assessed using specific endoscopic
and histologic scores.
Results
Faecal calprotectin showed a high correlation (r = 0.655) with the histologic grade of mucosal inflammation, similar to that observed
for endoscopy (r = 0.699), and it resulted the most accurate tool (sensitivity 94%, specificity 64%,
positive predictive value 81%, negative predictive value 87%) to detect the presence
of active mucosal inflammation when compared to clinical scores and common serum markers.
In patients with apparent clinical and laboratory remission the accuracy of faecal
calprotectin resulted further improved (sensitivity 100%, specificity 80%, positive
predictive value 67%, negative predictive value 100%).
Conclusions
A more accurate assessment of the severity of mucosal inflammation can be achieved
by the determination of faecal calprotectin levels compared to other common clinical
and laboratory indices. This non-invasive and objective method could be particular
useful in patients with apparent clinical and laboratory remission.
Keywords
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Article info
Publication history
Published online: March 25, 2008
Accepted:
January 30,
2008
Received:
August 6,
2007
Identification
Copyright
© 2008 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Inc. All rights reserved.
