Fecal Calprotectin In Patients Research Articles

Positive Correlation of Fecal Calprotectin With Serum Antioxidant Enzymes in Patients With Inflammatory Bowel Disease: Accidental Numerical Correlation or a New Finding?

BackgroundOxidative stress occuring in patients diagnosed with inflammatory bowel disease (IBD), but the relationship between oxidative stress, disease activity and inflammatory markers has not been well established. Materials and MethodsA total of 30 patients diagnosed with IBD and 30 volunteers who had normal colonoscopies, selected as controls, were used for this study. The serum levels of antioxidant enzymes (catalase and glutathione peroxidase) and oxidative markers (malondialdehyde [MDA] and total antioxidant capacity) were compared between the 2 groups. Furthermore, their correlations with disease activity scores and inflammatory markers, especially the fecal calprotectin, were examined. ResultsCatalase and glutathione peroxidase concentrations were significantly correlated with the level of fecal calprotectin in patients with IBD. Nevertheless, there were no significant correlations between the concentrations of the above-mentioned enzymes and C-reactive protein, erythrocyte sedimentation rate or the activity scores of IBD patients. It should be noted that MDA and total antioxidant capacity levels did not correlate with the inflammatory markers or the disease activity scores. ConclusionsThere was a positive correlation between fecal calprotectin and serum antioxidant enzymes in patients with IBD, but, there was no correlation between antioxidant and oxidative markers in terms of disease activity scores. Hence, the observed significant correlation between the antioxidant enzymes and the fecal calprotectin may be due to either the pro-oxidant potential of calprotectin or its antioxidant role.

Serial semi-quantitative measurement of fecal calprotectin in patients with ulcerative colitis in remission

Background: Fecal calprotectin (FC) correlates with clinical and endoscopic activity in ulcerative colitis (UC), and it is a good predictor of relapse. However, its use in clinical practice is constrained by the need for the patient to deliver stool samples, and for their handling and processing in the laboratory. The availability of hand held devices might spread the use of FC in clinical practice.Objectives: To evaluate the usefulness of a rapid semi-quantitative test of FC in predicting relapse in patients with UC in remission.Materials and methods: Prospective, multicenter study that included UC patients in clinical remission for ≥6 months on maintenance treatment with mesalamine. Patients were evaluated clinically and semi-quantitative FC was measured using a monoclonal immunochromatography rapid test at baseline and every three months until relapse or 12 months of follow-up.Results: One hundred and ninety-one patients had at least one determination of FC. At the end of follow-up, 33 patients (17%) experienced clinical relapse. Endoscopic activity at baseline (p = .043) and having had at least one FC > 60 μg/g during the study period (p = .03) were associated with a higher risk of relapse during follow-up. We obtained a total of 636 semi-quantitative FC determinations matched with a three-month follow-up clinical assessment. Having undetectable FC was inversely associated with early relapse (within three months), with a negative predictive value of 98.6% and a sensitivity of 93.9%.Conclusions: Serial, rapid semi-quantitative measurement of FC may be a useful, easy and cheap monitoring tool for patients with UC in remission.

The prognostic significance of faecal calprotectin in patients with inactive inflammatory bowel disease.

Faecal calprotectin, an established biomarker used to assess mucosal inflammation, has been shown to correlate with endoscopic activity in inflammatory bowel disease (IBD). Longitudinal monitoring of faecal calprotectin, however, has rarely been employed beyond assessment of therapy response and post hoc analyses of clinical trials. To study whether consecutive measurements of faecal calprotectin every third month are useful for monitoring patients with IBD in clinical remission. Patients aged 18 years or older, with a known diagnosis of IBD in clinical remission, were prospectively studied. Patients provided faecal samples every third month and were prospectively followed until the first clinical relapse or the end of the 2-year follow-up period. Measurements (EK-CAL, Bühlmann Lab. AG, Switzerland) were done at the end of the study. A Cox model with time-dependent covariates was used for analysis. Among 104 patients, Crohn's disease (n = 49) and ulcerative colitis (n = 55), 37 had a relapse. A doubling of faecal calprotectin level between two consecutively collected samples was associated with a 101% increased risk of relapse (HR: 2.01; 95% CI: 1.53-2.65; P < 0.001). The relative risk of relapse attenuated with time (HR: 0.80; 95% CI: 0.75-0.86; P < 0.001), by a 20% decrease in risk of relapse per 3-month period since the sample was obtained. By consecutively measuring faecal calprotectin every third month, we quantified the risk of relapse related to faecal calprotectin change and observed attenuation of the risk across time. Our data suggest that longitudinal monitoring of faecal calprotectin is informative in predicting relapse in IBD.

Faecal calprotectin in patients with suspected colorectal cancer: a diagnostic accuracy study.

NICE guidance exists for the use of faecal calprotectin (FC) when irritable bowel syndrome or inflammatory bowel disease are suspected. Often, however, colorectal cancer is considered within the differential. Should FC have a high diagnostic accuracy for colorectal cancer, it may be applicable as a primary care screening test for all patients with lower gastrointestinal symptoms. To determine the negative and positive predictive value (NPV/PPV) of FC in patients referred from primary care with suspected colorectal cancer. A diagnostic accuracy study conducted at a single secondary care site Consenting patients referred with suspected colorectal cancer within the '2-week wait' pathway provided a stool sample for FC prior to investigation. FC levels were reconciled with end diagnoses: cancer, adenomatous polyps ≥10 mm, and all enteric organic disease. A total of 654 patients completed the evaluation; median age 69 years, female 56%. The NPV for colorectal cancer was 98.6% and 97.2% when including polyps ≥10 mm. The PPV for all organic enteric disease was 32.7%. The diagnostic yield for cancer based on clinical suspicion was 6.3%. By altering the FC cut-off to fix the NPV at 97.0%, the PPV for cancer increased from 8.7% to 13.3%. FC has a high NPV for colorectal cancer and significant polyps in patients with suspected cancer. In total, 27.8% of patients had a normal FC and could safely have been spared a '2-week wait' referral. The addition of FC testing into the current symptom-based assessment has the potential to increase colorectal cancer detection rate yet be clinically and cost effective.

PWE-016 Faecal Calprotectin Has an Acceptable Sensitivity for Detecting Small Bowel Crohn’s Disease: Results from Real World Clinical Practice: Abstract PWE-016 Table 1

Introduction Faecal calprotectin ‘FC’ is a quick, non-invasive and inexpensive test proven to correlate well with colonic inflammation. It is used in our institution to also exclude active small bowel Crohn’s disease ‘CD’ although its reliability in such cases has recently been questioned. Using a higher cut-off FC value may exclude active disease in those with known inflammatory bowel disease with a higher specificity and reduce the number of false positives. 1,2 The aim of this study was to assess whether FC compared to gold standard magnetic resonance enterography ‘MRE’ can reliably be used in small bowel CD as a screening tool to select those needing further investigation. Methods Data from all CD patients who had undergone MRE to assess for active small bowel CD between January 2012 to November 2015 were reviewed. Patients with a known or new diagnosis of ileal or ileo-caecal crohn’s (Montreal classification L1 phenotype) or ileo-colonic crohn’s (L3 phenotype) with endoscopic and histologically-proven quiescent colonic disease were included. Data was analysed using Mann-Whitney U testing. Results 194 MREs were performed for investigation of possible small bowel CD during the study period. 64 patients were included for analysis; L1 disease = 90.6% (58 patients), L3 = 9.4% (6 patients). 50% were female. The median age was 48 years (range 17–76 years). Median time between FC and MRE was 30 days (range 0–180 days). 35 patients (54.7%) were Montreal disease behaviour B1, 24 patients (37.5%) with B2 and 5 patients (7.8%) with B3. 4 patients (6%) had peri-anal involvement. 26 patients (41%) had previous Crohn’s-related resectional surgery. 39 patients (60.9%) had evidence of active small bowel CD at MRE. The median FC in the active CD group was 246 mg/kg (IQR 556) and 49 mg/kg for the inactive small bowel disease group (IQR 177.5); p Table 1 shows results for sensitivity, specificity, positive predictive value ‘PPV’ and negative predictive value ‘NPV’ of different FC cut-off values in detecting any degree of small bowel activity at MRE. Conclusion In this study we compared FC results to MRE to exclude or confirm active small bowel CD in real-world clinical practice. This data demonstrates that by using a cut-off value of 50 mg/kg, an acceptable sensitivity for detecting active small bowel CD is achievable. However, at this cut-off value, specificity is low; nevertheless using FC will still reduce demand for MRE. References 1 F. Fasci-Spurio, A. Chiappini, V. Buonocore, S. Cannizzaro, Z. Maddalena, F. Maccioni, P. Vernia. (2014) Faecal calprotectin concentrations in Crohn’s patients with ileal disease location: correlations with disease activity as seen by MRI enterography. European Crohn’s and Colitis Organisation . 2 MF Hale, K Drew, ME McAlindon, AJ Lobo, R Sidhu. (2015). PTU-054 Faecal calprotectin in patients with suspected small bowel crohn’s disease: correlation with small bowel capsule endoscopy. Gut 2015 ;64:A83. doi:10.1136/gutjnl-2015-309861.169 Disclosure of Interest None Declared

PWE-026 7-Alpha-Cholestenone and Faecal Calprotectin in Patients with Collagenous Colitis

Introduction Collagenous colitis (CC) causes chronic, watery diarrhoea.1 Bile acid malabsorption (BAM) often accompanies CC2,3 and CC can respond to treatment with BA sequestrants.4 The European Microscopic Colitis Group (EMCG) advises that BAM should be sought in investigation for CC.1 The selenium-labelled homocholic acid-taurine (SeHCAT) test is considered the gold standard for BAM diagnosis; however, serum 7 alpha-hydroxy-4-cholesten-3-one (7 aC) is simpler and less expensive, with comparable sensitivity.5 Faecal calprotectin (FC) is well-established as a biomarker of bowel inflammation, but data in CC is scant.6 We present data from a tertiary referral centre on 7 aC and FC in patients with CC. Methods Pathology records were interrogated for patients diagnosed with CC (2000–2015), extracting results on 7 aC and FC. Results are presented as mean (±SD) or median (range). Results Over 15 years, 399 patients were diagnosed with CC (280 F/119 M). Of these, 164 were excluded from further analysis due to lack of appropriate data. 7 aC was available in 83 (20.8%) patients, mean levels of 11.5 ± 9.70 ng/ml. 11/83 (13.3%) patients had elevated 7 aC . FC levels were measured in 101 (25.3%) patients, mean levels 251.89 ± 282.62 µg/g. Of these, 76/101 (75.2%) had elevated FC ≥ 50 µg/g (FC ≥ 100 µg/g: 63/101; FC ≥ 200 µg/g: 30/101). Of the 101 patients with FC measurement, 76 had FC results ± 30 days from the point of histological diagnosis. In this group, median FC was 165 µg/g, range 20–1375 µg/g. Conclusion This is the first cohort data on 7 aC in CC. Our findings confirm that a significant proportion of CC patients have co-existing BAM; however, the incidence is lower than that reported in other studies using SeHCAT. The high incidence of raised FC in our cohort supports the position that FC is a useful marker of histologic inflammation in CC. References 1 Munch A, et al. Microscopic colitis: current status, present and future challenges: statements of the European Microscopic Colitis Group. J Crohns Colitis. 201;6:932–45. 2 Wildt S, et al. Bile Acid Malabsorption in Patients with Chronic Diarrhoea: Clinical Value of SeHCAT Test. Scand J Gastroenterol 2003;38:826–30. 3 Fernandez-Banares F, et al. Bile acid malabsorption in microscopic colitis and in previously unexplained functional chronic diarrhea. Dig Dis Sci 2001;46:2231–8. 4 Munch A, Langner C. Microscopic colitis: clinical and pathologic perspectives. Clin Gastroenterol Hepatol 2015;13:228–36. 5 Brydon W G, et al. An evaluation of the use of serum 7-alpha-hydroxycholestenone as a diagnostic test of bile acid malabsorption causing watery diarrhea. Can J Gastroenterol 2011;25:319–23. 6 Wildt S, et al. Metabolic and inflammatory faecal markers in collagenous colitis. Eur J Gastroenterol Hepatol 2007;19:567–74. Disclosure of Interest None Declared

Correlation of Fecal Calprotectin with Small Bowel MRI Findings in Crohn’s Disease

Objective : In Crohn’s disease, correlation of fecal neutrophil-derived biomarker calprotectin with small bowel magnet resonance enteroclysis (MRE) is scarcely studied. Methods : 51 consecutive Crohn’s disease patients undergoing MRE and having a measured fecal calprotectin at the time of the MRE were retrospectively studied. MRE findings were scored by an experienced radiologist according to a ranking taking into account 15 MRE variables. Furthermore, radiologist assessed the MRE findings as active, inactive or normal. Results : Median fecal calprotectin in patients with active ileal inflammation was significantly higher (281 μg/g, interquartil range IQR 66-574) than in those without signs of active inflammation in MRE (83 μg/g, IQR 48-245 p =0.0435). Fecal calprotectin correlated significantly with bowel wall thickening and enhancement detected in MRE. Using receiver operator characteristic curve, the highest sum for sensitivity (60%) and specificity (76%) was achieved at calprotectin concentration 213 μg/g to detect active Crohn’s disease. Conclusion : Fecal calprotectin correlates significantly with signs of active Crohn’s disease in MRE and is significantly higher among patients with active inflammatory MRE finding than in those without signs of active inflammation.

Tu1934 Assessment of Serum C-Reactive Protein, Fecal Lactoferrin, and Fecal Calprotectin in Patients With Moderate-Severely Active Crohns Disease: Results From the IM UNITI Maintenance Study

Tu1934 Assessment of Serum C-Reactive Protein, Fecal Lactoferrin, and Fecal Calprotectin in Patients With Moderate-Severely Active Crohns Disease: Results From the IM UNITI Maintenance Study

P573. Assessment of serum C-reactive protein, faecal lactoferrin, and faecal calprotectin in patients with Crohn’s disease: results from the UNITI-1 and UNITI-2 Ustekinumab induction studies

P573. Assessment of serum C-reactive protein, faecal lactoferrin, and faecal calprotectin in patients with Crohn’s disease: results from the UNITI-1 and UNITI-2 Ustekinumab induction studies

PTU-054 Faecal calprotectin in patients with suspected small bowel crohn’s disease: correlation with small bowel capsule endoscopy: Abstract PTU-054 Table 1

Introduction Faecal calprotectin (FC) is a stool biomarker recommended as a simple, non-invasive test to distinguish between inflammatory bowel disease (IBD) and functional bowel disorders. Despite a good correlation with colonic inflammation, FC is felt to be less accurate at identifying small bowel (SB) inflammation. Small bowel capsule endoscopy (SBCE) has a high sensitivity for detecting SB mucosal inflammation. We investigated the correlation between FC and SBCE in patients with suspected IBD. Method We prospectively correlated the findings of SBCE with FC levels in patients under investigation for suspected IBD. Patient demographics, clinical symptoms, medications and blood parameters: haemoglobin (Hb), albumin, ESR and CRP were collected. SBCE findings including Lewis scores were analysed against FC values and final diagnosis. Results 127 patients were included, mean age 42 years (range 18–75 years), 85 female. Presenting symptoms included: a combination of diarrhoea, abdominal pain and bloating (74%), diarrhoea alone (13%), abdominal pain alone (12%), rectal bleeding (1%). Median time from FC measurement to SBCE was 62 days. 12% had a family history of IBD, 14% were current smokers. 6 patients with a diagnosis of colonic pathology were excluded. Results are presented in Table 1. Of the 61 patients with FC >100 µg/g, 14 (23.0%) had clinically significant SB findings (12 SB ulcers, 2 villous atrophy) and mean FC levels 468 µg/g (range 112–1010 µg/g). Overall a definitive diagnosis was made in 10 patients (9 Crohn’s disease, 1 NSAID enteropathy), the remaining 10 patients are undergoing further evaluation. FC >50 µg/g was significantly associated with clinically relevant SBCE findings (χ² p = 0.02). FC had a sensitivity 81%, specificity 40%, positive predictive value 42% and negative predictive value (NPV) 80%. Receiver operating curve analysis showed an area under the curve (AUC) of 0.626 for FC, similar to CRP (AUC 0.638) but better than ESR (AUC 0.524) and Hb (AUC 0.545). Albumin most closely correlated with an AUC 0.686. Multiple logistical regression showed serum albumin to be the only variable significantly associated with positive SBCE (p = 0.032). Lewis score significantly correlated with FC value (r = 0.793, p Conclusion With a reasonable sensitivity and NPV, FC could be most effectively utilised to screen out patients where further SB investigation is unnecessary. However, in our series 1 patient with FC ≤50 µg/g had SB Crohn’s disease. Thus at best, FC can be only be recommended as an adjunct to clinical decision making, when patient factors and other biochemical parameters are also taken into account. Disclosure of interest None Declared.

PWE-074 Faecal calprotectin in predicting relapse in inflammatory bowel disease: a meta-analysis

<h3>Introduction</h3> Faecal calprotectin (FCP) is a non-invasive marker of gastrointestinal inflammation. Its utility in the clinical management of inflammatory bowel disease (IBD) is under evaluation. We aimed to perform a meta-analysis of prospective studies in assessing the ability of baseline FCP for predicting relapse with 12 months in patients with Crohn’s disease (CD) and ulcerative colitis (UC) in clinical remission. <h3>Method</h3> Multiple electronic databases were searched including Pubmed, Embase and Ovid looking for studies providing data on relapse prediction in IBD using FCP. Pooled sensitivity, specificity, negative (LR-) and positive (LR=+ predictive value diagnostic odds ratio (DOR) and pooled area under the receiver operating characteristic (AUROC) was calculated. A random effects model was used and publication bias was assessed using Funnel plots and Egger’s test and heterogeneity was assessed using Cochran’s Q and the I²test. <h3>Results</h3> 8 studies involving 507 patients with CD and 8 studies involving 587 patients with UC were included. The predictive value for a relapse within 12 months for baseline FCP in patients with CD was sensitivity 73% (64–80), specificity 78% (74–82), LR+ 2.9 (1.9–4.5), LR- 0.4 (0.2–0.6), DOR 10.1 (4.5–22.6) and AUROC 0.83 (±0.04). The cut off for baseline FCP used for the CD studies ranged from 130–340 µg/g. The predictive value for a relapse within 12 months for baseline FCP in patients with UC was sensitivity 72% (65–77), specificity 78% (74–83), LR+ 3.0 (2.3–4.0), LR- 0.4 (0.2–0.6), DOR 9.2 (5.4–15.7) and AUROC 0.82 (±0.03). The cut off for baseline FCP used for the UC studies ranged from 130–250 µg/g. There was significant heterogeneity (I²&gt; 50%) for all the analysis likely because of the differences in relapse rates and FCP cut off values used. <h3>Conclusion</h3> FCP is a simple non-invasive marker with the potential to predict replase in IBD. With pooled sensitivity and specificity under 80% for both CD and UC, its value may be mainly to identify low risk patients. However wide variations in the cut off values for FCP used in these studies makes it difficult to apply this to routine clinical practice. Serial measurements of FCP to check for a rise from baseline may be the way forward for future studies. <h3>Disclosure of interest</h3> None Declared.

Faecal calprotectin as a marker for oesophago-gastric cancer.

Faecal calprotectin has been shown to be useful as a non-invasive screening test to differentiate functional from organic bowel disease, and it has been noted to be elevated in colorectal cancer. The aim of this study was to describe concentrations of faecal calprotectin in patients with oesophago-gastric cancer and investigate any potential discriminatory power of the test. Faecal calprotectin was measured in samples from 39 patients with known oesophago-gastric cancer and in 191 samples from control subjects. The median calprotectin concentration was < 20 µg/g (range < 20-421 µg/g) in control subjects and 97 µg/g (range < 20-940 µg/g) in patients with oesophago-gastric cancer (P < 0.001). A receiver operating characteristic curve gave an area under the ROC curve of 0.84 and a sensitivity of 76.9% (95% CI: 63.7-90.1%) and specificity of 88.0% (95% CI: 83.3-92.6%) at a cutoff of 50 µg/g. Faecal calprotectin is elevated in patients with cancer of the upper gastrointestinal tract. This study suggests that calprotectin may be promising in discriminating cancer patients from controls, but further work is required to explore any potential role of faecal calprotectin in screening for, or diagnosis of, oesophago-gastric cancer.

Fecal calprotectin in patients with suspected small bowel disease – a selection tool for small bowel capsule endoscopy?

Objective. Fecal calprotectin (FC) has been proposed as a selection tool for gastrointestinal examinations, but the use of FC in the diagnosis of small bowel disease in particular is less studied. The aim of this study was to assess if FC could be used to predict findings on small bowel capsule endoscopy (SBCE). Material and methods. We retrospectively collected FC values, SBCE findings and clinical data in 161 patients with suspected small bowel disease referred for SBCE. Findings on SBCE were correlated with FC levels and the diagnostic value of FC was assessed. Results. Of the 161 patients, 37.3% had a positive FC and 29.8% had a finding on SBCE. Overall there was a significant difference in FC values between patients with any finding on SBCE and patients with a normal SBCE, but patients with ulcers/erosions was the only subgroup of patients with FC values significantly higher than patients with a normal SBCE. The proportion of patients with findings on SBCE increased with increasing FC value. A positive FC (≥50 mg/kg) had a sensitivity, specificity, positive predictive value and negative predictive value of 54.2%, 69.9%, 43.3% and 78.2%, respectively, for predicting findings on SBCE. Conclusions. FC alone cannot be used as a selection tool for SBCE in patients with suspected small bowel disease in a specialist setting. However, a high FC value implies a higher probability of finding significant pathology on SBCE, and thus strengthens the indication for performing the examination.

Fecal calprotectin is a useful marker to diagnose ulcerative colitis from irritable bowel syndrome.

Background:This study was aimed to evaluate the predictive value of fecal calprotectin in patients with ulcerative colitis from patients with irritable bowel syndrome (IBS).Materials and Methods:Between May and October 2013, 88 adult patients, between the age 18 and 65 years with a history of chronic diarrhea of unknown origin were assessed. Standard colonoscopies were performed in all patients to assess ulcerative colitis. Before colonoscopies, they were asked to supply a stool specimen. Fecal calprotectin value was measured using a commercial enzyme-linked immunosorbent assay kit.Results:The mean of age, gender combination, and body mass index were not significantly different between patients with ulcerative colitis or IBS. The duration of disease in ulcerative colitis patients was significantly higher than IBS patients (P < 0.0001). The level of calprotectin in ulcerative colitis patients was significantly higher than IBS patients (265.9 vs 115.8, respectively, P = 0.001). Also, cutoff value >164 μg/g with sensitivity and specify of 57 (CI: 41%–71.6%), and 75 (CI: 59.7%–56.8%), respectively, was the best for discrimination between patients with ulcerative colitis and those with IBS.Conclusion:Our results show that fecal calprotectin as a noninvasive method, which can be used to identify patients with ulcerative colitis from IBS patients has low sensitivity and specificity.

PWE-077 Access To A Faecal Calprotectin Service Provides Clinicians With The Confidence To Diagnose And Treat Concomitant Functional Bowel Symptoms In Known Ibd Patients

IntroductionAn accurate clinical assessment of disease activity in inflammatory bowel disease (IBD) is essential to provide appropriate management strategies. The concurrent presence of functional symptoms in IBD patients is common...

212 Serum CRP Is a Better Early Marker for Response to Infliximab Induction Therapy Than Fecal Calprotectin in Patients With Moderate to Severe Ulcerative Colitis

212 Serum CRP Is a Better Early Marker for Response to Infliximab Induction Therapy Than Fecal Calprotectin in Patients With Moderate to Severe Ulcerative Colitis

Mesalamine Dose Escalation Reduces Fecal Calprotectin in Patients With Quiescent Ulcerative Colitis

Among patients with quiescent ulcerative colitis (UC), lower fecal concentrations of calprotectin are associated with lower rates of relapse. We performed an open-label, randomized controlled trial to investigate whether increasing doses of mesalamine reduce concentrations of fecal calprotectin (FC) in patients with quiescent UC. We screened 119 patients with UC in remission on the basis of Simple Clinical Colitis Activity Index scores, FC >50 μg/g, and intake of no more than 3 g/day mesalamine. Participants taking mesalamine formulations other than multimatrix mesalamine were switched to multimatrix mesalamine (2.4 g/day) for 6 weeks; 52 participants were then randomly assigned (1:1) to a group that continued its current dose of mesalamine (controls, n= 26) or a group that increased its dose by 2.4 g/day for 6 weeks (n= 26). The primary outcome was continued remission with FC <50 μg/g. Secondary outcomes were continued remission with FC <100 μg/g or <200 μg/g (among patients with pre-randomization values above these levels). The primary outcome was achieved by 3.8% of controls and 26.9% of the dose escalation group (P= .0496). More patients in the dose escalation group reduced FC to below 100 μg/g (P= .04) and 200 μg/g (P= .005). Among the patients who were still in remission after the randomization phase, clinical relapse occurred sooner in patients with FC >200 μg/g compared with those with FC <200 μg/g (P= .01). Among patients with quiescent UC and increased levels of FC, increasing the dose of mesalamine by 2.4 g/day reduced fecal concentrations of calprotectin to those associated with lower rates of relapse. Clinicaltrials.gov number: NCT00652145.

P350 Serum CRP is a better early marker for response to infliximab induction therapy than fecal calprotectin in patients with moderate to severe ulcerative colitis

P350 Serum CRP is a better early marker for response to infliximab induction therapy than fecal calprotectin in patients with moderate to severe ulcerative colitis

Stool calprotectin in necrotizing enterocolitis.

Background:Calprotectin is a 36 kDa protein present in the cytoplasm of the neutrophil has antimicrobial and apoptosis inducing activities. In vitro studies have shown that calprotectin inhibits the growth of various microorganisms. Necrotizing enterocolitis (NEC) remains one of the leading causes of morbidity and mortality in neonatal intensive care units (NICU), affecting up to 5% of premature infants. Fecal calprotectin is resistant to degradation and has been proposed as a useful marker of gastrointestinal inflammation.Objective:The objective of the present study is to evaluate fecal calprotectin concentrations in NEC.Study Design:Fifteen neonates with a clinical diagnosis of NEC were studied; they admitted at NICU of Zagazig University Hospital. In addition, 20 age sex matched neonates fed all caloric requirement served as the control group. All neonates were subjected to history taking, clinical examination, laboratory investigations (complete blood count, C-reactive protein) and determination of stool calprotectin.Results:There was a highly significant increase in fecal calprotectin in patients than control and there was a highly significant increase in its fecal level in died patients than living one. Also significant increase in fecal calprotectin level with increasing severity of NEC.Conclusion:Fecal calprotectin measurements could be a valuable tool for the investigation of preterm and full term infants suspected of having NEC.

PTH-136 Faecal Calprotectin - Is it Requested Appropriately and is it Cost Effective?

IntroductionFaecal calprotectin is a neutrophil derived protein that can be detected by quantitative enzyme linked immunosorbant assay in stool samples. It reliably predicts the level of mucosal inflammation in the...