Abstract
Background and study aim: We aimed to evaluate the validity and accuracy of the faecal calprotectin in differentiating patients with IBD from those with IBS and in the assessment of the severity of intestinal mucosal inflammation in patients with ulcerative colitis (UC) which may facilitate in the prognosis and follow. Patients and Methods: We studied 60 Patients who came to endoscopy unit with lower gastroenterological symptoms. Patients with history of infections, malignancy, gastrointestinal surgery, pregnancy, alcohol abuse or taking nonsteroidal anti-inflammatory drugs were excluded from study. All patients subjected to thorough medical history, simple clinical colitis activity index was determined with a score ˃ 4 indicate active UC, complete blood picture, liver, kidney function tests, ESR, CRP, ANCA were done, a stool sample for FC levels determined by a highly sensitive enzymelinked immunosorbent assay and total colonoscopy with histological examination of intestinal mucosa biopsy were done. The patients divided into 2 groups. Group A: patients with UC, group B: patients with manifestation of irritable bowel syndrome as a control group. Results: There was a high significant difference between individuals with no pathological activity and other degree of mucosal inflammation as regard simple clinical colitis activity index, endoscopic appearance and faecal calprotectin (p = 0.000). The sensitivity, specificity, positive predictive value and negative predictive value of faecal calprotectin in diagnosis of UC were 93.5%, 89.7%, 90.6%, and 92.9% respectively. The positive predictive value and negative predictive value of simple clinical colitis activity index for diagnosis of UC were 76.5% and 80.8% respectively. The positive predictive value and negative predictive value of endoscopic appearance for diagnosis of UC were 100%, and 85.3% respectively. There was a high significant difference and positive correlation between faecal calprotectin, score of colonic pathological activity, endoscopic appearance and simple clinical colitis activity index. Conclusion: Faecal calprotectin is highly useful for the diagnosis and disease monitoring of patients with UC as it is easy, non invasive, reliable tool
Highlights
The cause of ulcerative colitis (UC) is currently under examination
Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are common entities. Both conditions may present with similar clinical features such as diarrhea and abdominal pain
Our study revealed that level of faecal calprotectin was higher in inflammatory bowel disease (IBD) patients than in non-IBD patients, which is matched by a study conducted by von Roon et al, [13] who stated that fecal calprotectin was higher in IBD patients than in non-IBD patients, and showed excellent pool sensitivity and specificity rates in distinguishing between these groups (95% and 91%, respectively)
Summary
The cause of ulcerative colitis (UC) is currently under examination. It is believed that the 2 idiopathic forms of inflammatory bowel disease (IBD), ulcerative colitis and Crohn's disease (CD), develop secondary to complex interactions among genetic predispositions, environmental risk factors, and the immune system.El-khashab et al, Afro-Egypt J Infect Endem Dis 2012; 2(4): 162-167 www.mis.zu.edu.eg/ajied/home.aspxSeveral genes likely play a role; their products, when combined with environmental factors and dysfunctional immunity, result in a disease spectrum with heterogeneous manifestations and many unique phenotypes [1].The determination of inflammatory activity is crucial for patients with IBD for the diagnosis, monitoring and step up of therapy. The cause of ulcerative colitis (UC) is currently under examination. It is believed that the 2 idiopathic forms of inflammatory bowel disease (IBD), ulcerative colitis and Crohn's disease (CD), develop secondary to complex interactions among genetic predispositions, environmental risk factors, and the immune system. Several genes likely play a role; their products, when combined with environmental factors and dysfunctional immunity, result in a disease spectrum with heterogeneous manifestations and many unique phenotypes [1]. The determination of inflammatory activity is crucial for patients with IBD for the diagnosis, monitoring and step up of therapy. Laboratory markers have been studied intensively with varying degrees of success. The widely used acute phase protein C-reactive protein in this respect is a less good marker for assessing disease activity in UC than Crohn's disease [3]
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