P-057A: Detecting inflammation in pediatric inflammatory bowel disease: the role of fecal calprotectin and its impact on management

Abstract

Introduction: Fecal calprotectin (FC) is a calcium binding protein found in the cytoplasm of neutrophils, monocytes and macrophages. FC levels can be used as a marker of inflammation in inflammatory bowel disease (IBD) patients. Aim: The aim of this study is to explore the current use of FC at our pediatric hospital, and to assess the impact of FC results on patient management. Methods: We performed a retrospective chart review of all IBD patients who had an FC level checked between January 2012 and January 2014. Demographic information, laboratory values and the indications for checking FC were collected. We documented any change in patient management that occurred as a result of the FC value. Results: Forty-seven patients were included in our review. Thirty-seven of the patients (79%) were found to have FC levels greater than 200 mg/g indicating active ongoing inflammation. Thirteen of thirty-seven patients (35%) with elevated FC levels had normal routine blood work screening (including erythrocyte sedimentation rate and c-reactive protein). The FC level resulted in management changes in 32/47 patients (68%). Conclusion: FC was a valuable screening test for inflammation in children with IBD in our center. FC detected inflammation in a subgroup of patients with otherwise normal screening inflammatory markers. FC also provided new information to the physician that frequently resulted in a change in management.