Akutko Katarzyna, Iwańczak Barbara
2nd Department of Paediatrics, Gastroenterology and Nutrition, Faculty of Medicine, Wroclaw Medical University, 50-369 Wroclaw, Poland.
J Clin Med. 2022 Oct 15;11(20):6086. doi: 10.3390/jcm11206086.
Background: The development of diagnostic and monitoring algorithms for Crohn’s disease based on non-invasive methods is of particular importance in children and is the subject of many studies. Objectives: Evaluate the usefulness of fecal calprotectin, serum C-reactive protein, erythrocyte sedimentation rate, seromucoid and procalcitonin in the differential diagnosis of non-inflammatory gastrointestinal tract diseases and Crohn’s disease in children and their usefulness in determining the phenotype of Crohn’s disease. Material and methods: Forty-seven children with non-inflammatory gastrointestinal tract diseases and fifty-four with Crohn’s disease were enrolled. Clinical and endoscopic activity was evaluated based on the Pediatric Crohn’s Disease Activity Index (PCDAI) and the Simple Endoscopic Score for Crohn’s Disease (SES-CD). Results: Fecal calprotectin, C-reactive protein, erythrocyte sedimentation rate and seromucoid were significantly higher in children with Crohn’s disease than in controls (p < 0.001). Fecal calprotectin correlated with clinical and endoscopic activity according to the Pediatric Crohn’s Disease Activity Index (r = 0.338; p = 0.012) and the Simple Endoscopic Score for Crohn’s Disease (r = 0.428; p = 0.001). Non-invasive biomarkers did not correlate with the location and clinical manifestation of Crohn’s disease. Conclusions: Fecal calprotectin, C-reactive protein, erythrocyte sedimentation rate and seromucoid are useful in the differentiation of Crohn’s disease from non-inflammatory gastrointestinal tract diseases in children and in monitoring the clinical course of Crohn’s disease, but not in evaluating activity and phenotype of the disease.
基于非侵入性方法开发克罗恩病的诊断和监测算法在儿童中尤为重要，也是许多研究的主题。目的：评估粪便钙卫蛋白、血清C反应蛋白、红细胞沉降率、血清类粘蛋白和降钙素原在儿童非炎性胃肠道疾病和克罗恩病鉴别诊断中的作用及其在确定克罗恩病表型方面的作用。材料与方法：纳入47例非炎性胃肠道疾病患儿和54例克罗恩病患儿。根据儿童克罗恩病活动指数（PCDAI）和克罗恩病简易内镜评分（SES-CD）评估临床和内镜活动度。结果：克罗恩病患儿的粪便钙卫蛋白、C反应蛋白、红细胞沉降率和血清类粘蛋白显著高于对照组（p < 0.001）。根据儿童克罗恩病活动指数，粪便钙卫蛋白与临床和内镜活动度相关（r = 0.338；p = 0.012），与克罗恩病简易内镜评分也相关（r = 0.428；p = 0.001）。非侵入性生物标志物与克罗恩病的部位和临床表现无关。结论：粪便钙卫蛋白、C反应蛋白、红细胞沉降率和血清类粘蛋白有助于儿童克罗恩病与非炎性胃肠道疾病的鉴别以及监测克罗恩病的临床病程，但对评估疾病的活动度和表型无帮助。
