Department of Medicine, Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital , Oslo , Norway.
Infect Dis (Lond). 2015 Mar;47(3):137-43. doi: 10.3109/00365548.2014.974206. Epub 2014 Dec 18.
The diagnosis of intestinal tuberculosis (ITB) is sometimes difficult to establish and requires endoscopic investigation with biopsies for histopathological examination. This study aimed to evaluate calprotectin as a marker of inflammation in ITB.
Patients with ITB were prospectively recruited in Southern India from October 2009 until July 2012. Demographic, clinical, endoscopic and histological features were examined along with faecal calprotectin (FC), serum calprotectin (SC) and C-reactive protein (CRP).
Thirty patients (median age 34.5 years, 19 men) were included. Clinical features were abdominal pain (97%), weight loss (83%), cachexia (75%), fatigue (63%), watery diarrhoea (62%), nausea (55%) and fever (53%). Endoscopy showed transverse ulcers (61%), nodularity of mucosa (55%), aphthous ulcers (39%), strictures (10%) and fissures (10%). The terminal ileum and right colon harboured 81% of the lesions. Histology revealed granulomas in biopsies from 10 of the patients. FC and CRP levels showed a strong positive correlation (rs = 0.70, p < 0.01). FC, SC and CRP levels were higher in the granulomatous than the non-granulomatous patients, respectively (median FC 988 μg/g, interquartile range (IQR) 940 vs 87 μg/g, IQR 704, p < 0.01; median SC 8.2 μg/ml, IQR 7.3 vs 3.8 μg/ml, IQR 8.9, p = 0.23; median CRP 38.8 mg/L, IQR 42.9 vs 2.3 mg/L, IQR 13.5, p < 0.01). Higher median calprotectin and CRP levels were detected in patients with extensive than localized disease, but the differences did not reach statistical significance.
ITB patients with granulomas on histology have high levels of faecal calprotectin and CRP.
肠结核（ITB）的诊断有时较为困难，需要进行内镜检查并进行活检以进行组织病理学检查。本研究旨在评估钙卫蛋白作为 ITB 炎症标志物的作用。
2009 年 10 月至 2012 年 7 月，在印度南部前瞻性招募 ITB 患者。检查患者的人口统计学、临床、内镜和组织学特征，以及粪便钙卫蛋白（FC）、血清钙卫蛋白（SC）和 C 反应蛋白（CRP）。
共纳入 30 例患者（中位年龄 34.5 岁，19 名男性）。临床特征为腹痛（97%）、体重减轻（83%）、恶病质（75%）、乏力（63%）、水样腹泻（62%）、恶心（55%）和发热（53%）。内镜检查显示横形溃疡（61%）、黏膜结节（55%）、口疮样溃疡（39%）、狭窄（10%）和裂隙（10%）。病变主要位于末端回肠和右半结肠（81%）。10 例患者的活检显示肉芽肿。FC 和 CRP 水平呈强正相关（rs = 0.70，p < 0.01）。肉芽肿性患者的 FC、SC 和 CRP 水平分别高于非肉芽肿性患者（中位 FC 988 μg/g，IQR 940 与 87 μg/g，IQR 704，p < 0.01；中位 SC 8.2 μg/ml，IQR 7.3 与 3.8 μg/ml，IQR 8.9，p = 0.23；中位 CRP 38.8 mg/L，IQR 42.9 与 2.3 mg/L，IQR 13.5，p < 0.01）。广泛病变患者的 FC 和 CRP 中位水平高于局限性病变患者，但差异无统计学意义。
组织学上有肉芽肿的 ITB 患者的粪便钙卫蛋白和 CRP 水平较高。
