Gaya, D.R., Lyon, T.D.B., Duncan, A., Neilly, J.B., Han, S., Howell, J., Liddell, C., Stanley, A.J., Morris, A.J. and Mackenzie, J.F. (2005) Faecal calprotectin in the assessment of Crohn's disease activity. QJM: An International Journal of Medicine, 98(6), pp. 435-441. (doi: 10.1093/qjmed/hci069) (PMID:15879440)
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Abstract
Background: Clinical and laboratory assessment of activity in Crohn's disease (CD) correlate poorly with endoscopic findings. Calprotectin is a calcium-binding protein abundant in neutrophil cytosol, and extremely stable in faeces. Faecal calprotectin (FC) is an excellent surrogate marker of neutrophil influx into the bowel lumen. Aim: To assess whether FC concentration from a spot stool sample reliably detects active inflammation in patients with CD. Design: Cross-sectional comparative study. Methods: Subjects had a previously confirmed diagnosis of CD and were suspected on clinical grounds to be in the midst of a relapse. Thirty-five entered the study; they underwent radiolabelled white cell scanning (WCS) and had a stool sample collected for calprotectin measurement on the same day. A Crohn's disease activity index (CDAI) was also calculated for each. The WCS scans were scored at six standard sites to give a mean total, ‘extent‘, ‘severity’ and ‘combined extent and severity’ scores. Results: FC was significantly and positively correlated with mean total (r = 0.73, p<0.001), ‘extent’ (r = 0.71, p<0.001), ‘severity’ (r = 0.64, p<0.001) and combined ‘extent and severity’ WCS scores (r = 0.71, p<0.001). A cut-off of faecal calprotectin >100 µg/g gave a sensitivity of 80%, specificity of 67%, positive predictive value of 87% and a negative predictive value of 64% in identifying those with and without any inflammation on WCS. There was, however, no significant correlation between CDAI and mean total WCS score (r = 0.21, p = 0.24), nor between CDAI and FC (r = 0.33, p = 0.06). Discussion: While the CDAI does not accurately reflect inflammatory activity in CD, a one-off FC reliably detects the presence or absence of intestinal inflammation in adult patients with CD, compared to WCS.
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Gaya, Mr Daniel |
Authors: | Gaya, D.R., Lyon, T.D.B., Duncan, A., Neilly, J.B., Han, S., Howell, J., Liddell, C., Stanley, A.J., Morris, A.J., and Mackenzie, J.F. |
College/School: | College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
Journal Name: | QJM: An International Journal of Medicine |
Publisher: | Oxford University Press |
ISSN: | 1460-2725 |
ISSN (Online): | 1460-2393 |
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