Fecal Calprotectin as early predictor for screening and relapse in pediatric chronic diarrhea in India

Abstract

: IBS and IBD are two abdomen ailments commonly seen in children. IBD is a life-long disorder that includes two major forms of chronic illness UC and CD, IBS may occur when the bowel is sensitive to specific foods or other triggers like stress. The aims of the study is to investigate clinical usefulness of FC as early predictor for screening and differentiating IBD and IBS and to monitor the treatment for relapse and remission in pediatric Indian population. This was hospital based observational cohort study, conducted over a period of twelve months from January 2019 to December 2019 Total 325 patients attending OPD were included in the study, in children between 1-18years in which FC was measured using commercially available CLIA kit. HB, ESR, Hscrp were also assessed, these patients were followed up. Patients were grouped asGroup I: IBS: 115(50:65M/F), Group II: 185 IBD, had Subgroup I:116 CD(48:68M/F);Group A: 62.7% presented with relapse Group B: 37.3% had disease in remission Subgroup II: 69 patients had UC(31:38 M/F); Group A: 60.9% had relapse and Group B: 39.1% in remission after follow up. Subgroup III: Others were 25(7.7%). In Study I: Levels of FC were significantly lower in patients with group I when compared to group II. In Subgroup I & Subgroup II Group A had higher FC levels when compared to group B. In Study II: A significant difference (P<0.001) and lower values of the FC, ESR, Hs-crp, frequency of stools in IBS than in CD and UC patients were observed. In Study III: FC in IBD has positive correlation (p<0.01), with the activity of the inflammatory disorder, HB, ESR, Hs-CRP and with increased frequency of diarrhea. In Study IV Fecal calprotectin value of ≥100 ug/g was diagnostic of IBD with sensitivity of 94.1%, specificity of 82.2%, PPV of 86.32%, NPV of 80.39%. The present study showed that the determination of FC assists to differentiate between IBD and IBS also useful in monitoring of remission and in early prediction of relapse in pediatric IBD.