P-045A: Prediction of relapse using consecutive measurements of fecal calprotectin in pediatric Crohn’s disease patients

Abstract

Background: An accurate monitoring of mucosal inflammation is important for an effective management of children with inflammatory bowel disease (IBD). Objectives: The aim of the study was to evaluate the efficacy of fecal calprotectin (Cal) as indicator of inflammatory activity in children with Crohn’s disease (CD) and ulcerative colitis (UC) by correlating it with biological, clinical and endoscopic indices. Methods: A total of 22 children presenting IBD were evaluated (16CD/6UC). Fecal Cal, blood tests, Pediatric CD Activity Index(PCDAI), Pediatric UC Activity Index (PUCAI), CD Endoscopic Index of Severity (CDEIS) and Mayo Disease Activity Index (MDAI) were used for evaluation at diagnosis and after one year of treatment. Results: In CD children, Cal proved a high correlation (r = 0.775) with mucosal inflammation, showed by CDEIS and a medium correlation with CRP (r = 0.623). It didn’t correlate with PCDAI (r = 0.325). In UC children, Cal correlated moderate (r = 0.581) with CRP and it was strongly correlated with PUCAI (r = 0.752) and MDAI (r = 0.796). Cal levels decreased significantly after one year of treatment in all patients (p = 0.038). Conclusions: In CD children fecal Cal was more accurate in detection mucosal inflammation when compared to clinical score and CRP. The poor correlation between Cal and PCDAI may be due to the fact that PCDAI is mostly a clinical score, not sensitive enough to detect subclinical activity of the disease. Fecal Cal correlated well with endoscopic indices both in CD and UC children, being valuable not only for IBD screening, but also for monitoring disease activity and reducing the need for colonoscopy in children.