[Assessment of fecal calprotectin concentration as inflammatory marker in inflammatory bowel diseases in children--preliminary report].

UNLABELLED

Among patients with inflammatory bowel disease children constitute about 15-20%. Still is ongoing search for the perfect marker for this large group of patients which will help in the diagnosis of the disease, in determination of its activity, in monitoring the treatment and in predicting the relapse, while the test for that marker would be simple, cheap and noninvasive. One of the antimicrobial peptide-calprotectin, which is present in feces and is dependent on the number of migrating granulocytes into the intestinal lumen, is a promising marker of the severity of inflammation. The aim of the study was to evaluate the usefulness of the application of calprotectin measurement in stool in children with inflammatory bowel disease, as a marker of the severity of inflammation.

MATERIAL AND METHODS

We analyzed 115 patients: 32 with ulcerative colitis (UC), 44 with Crohn's disease (CD), 9 with hemorrhagia from the lower part of the digestive tract, but without inflammatory bowel disease and 30 from the control group. In all patients were measured the concentration of calprotectin in the sample of feces using CALPRO (Calprotectin ELISA test) and markers of inflammation: erythrocyte sedimentation rate (ESR), CRP protein, leukocytosis in the peripheral blood counts (L), concentration of seromucoid and the number of platelets (Tr) and hemoglobin (Hb).

RESULTS

Concentration of calprotectin in feces of patients with inflammatory bowel diseases was above the norm I (> 50 mg/kg b.w.) in all patients with moderate and severe disease and in the majority of patients with mild disease or in remission. In contrast it was normal in all from control group. Fecal calprotectin concentration was higher than normal in connection with abnormal results of laboratory parameters such as inflammatory markers in serum and haemoglobin concentration. Laboratory abnormalities were more frequent in patients with IBD and with fecal calprotectin level above the norm than in all patients with IBD.

CONCLUSIONS

1. Calprotectin concentration in stool above of norm was observed in the majority of patients with inflammatory bowel disease, and in none from the control group. 2. The number of patients with IBD and higher fecal calprotectin concentration increased with disease activity 3. Fecal calprotectin concentration was higher in patients with severe and moderate disease activity than in those with mild disease activity or in remission. 4. Calprotectin fecal concentration in patients with inflammatory bowel disease was associated with increased other inflammatory markers in serum and decreased haemoglobin. 5. Measurement of fecal calprotectin concentration can be an noninvasive method of assessment disease activity in inflammatory bowel diseases.