FECAL CALPROTECTIN DIFFERENTIATES BETWEEN CHILDREN WITH ACTIVE INFLAMMATORY BOWEL DISEASE (IBD) AND HEALTHY CHILDREN

Abstract

Background: Calprotectin is a calcium- binding protein released by myelomonocytic cells during inflammation. Fecal calprotectin (FC) is elevated in patients with IBD and may fluctuate according to disease activity. Aims: 1) Compare levels of FC in healthy children to those with IBD. 2) Compare FC levels within the IBD group (flare vs. remission). Methods: FC was measured by ELISA using 134 stool samples (37 from healthy controls, 76 from Crohn disease (CD) patients and 21 from ulcerative colitis (UC) patients). Normal FC level was defined as <50 mcg/g of stool. Disease activity in 32 IBD patients (56 samples) was assessed by the physician global assessment within 2 weeks of sample submission. The Harvey-Bradshaw index (HBI) was calculated in CD patients. Analysis was performed using the Wilcoxon rank sum test. Results: See Table 1. As a group IBD patients had higher FC levels than healthy controls (p < 0.0001). Patients with active IBD had significantly higher FC levels than controls with no overlap in FC concentrations (p < 0.0001). FC levels were higher in disease flare than remission (p < 0.0001); however there was some overlap in FC levels (p < 0.0001). The correlation coefficient between the HBI and FC levels in patients with CD was 0.36, p < 0.02.Table 1Conclusions: FC levels can be used to differentiate children with active IBD from healthy controls. FC levels failed to clearly differentiate disease flare from remission in IBD patients. There is not a clear relationship between HBI and FC as a predictor of relapse. Further investigation of the predictive value of FC in determining relapse in a cohort with clinical remission is needed.