Rohani Pejman, Beheshti Narjes Raja, Alimadadi Hosein, Sohouli Mohammad Hassan
Pediatric Gastroenterology and Hepatology Research Center, Department of Pediatrics, Pediatrics Centre of Excellence, School of Medicine Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Allergy Asthma Clin Immunol. 2022 Sep 30;18(1):86. doi: 10.1186/s13223-022-00728-5.
Fecal calprotectin (FC) is a noninvasive biomarker for assessing the inflammatory status of the gastrointestinal tract. The aim of this study was to determine the association between FC levels and Eosinophilic colitis (EC) before and after treatment in pediatrics.
In this cross-sectional study, 330 patients with rectorrhagia and FC levels > 200 μg/g were included in the study. Patients were then subjected to colonoscopy, and if 30 or more eosinophils were observed in the pathology of at least two parts of the colon, EC was diagnosed. Of the 330 patients included in the study, 14 patients were diagnosed as EC. Treatment included seven food elimination diet (food allergens) for 3 months. After 3 months, FC levels were repeated and colonoscopy was performed.
The mean age of the children was 5.9 years. After the elimination diet, the number of eosinophils in all segments of colon significantly decreased (P < 0.001) and according to the pathology report, the number of eosinophils improved in 42.9% of patients. Also, the mean number of segments involved in the colon of patients was significantly decreased (P < 0.001). Mean FC levels were significantly decreased after 3 months (P < 0.001). The cut-off point of 114 μg/g of FC had sensitivity (75%), specificity (67%), positive predictive value (75%), negative predictive value (67%), accuracy (71.4%), and area under the ROC curve (0.708) acceptable in predicting EC.
This study showed that FC levels can be elevated in patients with EC, which is easily corrected with a targeted elimination of food allergens.
粪便钙卫蛋白（FC）是一种用于评估胃肠道炎症状态的非侵入性生物标志物。本研究的目的是确定儿科患者治疗前后FC水平与嗜酸性粒细胞性结肠炎（EC）之间的关联。
在这项横断面研究中，纳入了330例有直肠出血且FC水平>200μg/g的患者。然后对患者进行结肠镜检查，如果在结肠至少两个部位的病理检查中观察到30个或更多嗜酸性粒细胞，则诊断为EC。在纳入研究的330例患者中，14例被诊断为EC。治疗包括为期3个月的七种食物排除饮食（食物过敏原）。3个月后，重复检测FC水平并进行结肠镜检查。
儿童的平均年龄为5.9岁。排除饮食后，结肠各段嗜酸性粒细胞数量显著减少（P<0.001），根据病理报告，42.9%的患者嗜酸性粒细胞数量有所改善。此外，患者结肠受累段的平均数量显著减少（P<0.001）。3个月后FC平均水平显著降低（P<0.001）。FC水平为114μg/g的截断点在预测EC方面具有可接受的敏感性（75%）、特异性（67%）、阳性预测值（75%）、阴性预测值（67%）、准确性（71.4%）和ROC曲线下面积（0.708）。
本研究表明，EC患者的FC水平可能升高，通过有针对性地排除食物过敏原可轻松纠正。
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