Plume Jack L, De Anita, Mutalib Mohamed
Faculty of Life Sciences and Medicine, King's College London (Jack L. Plume, Anita De, Mohamed Mutalib).
Department of Paediatric Gastroenterology, Evelina London Children's Hospital, London (Mohamed Mutalib), UK.
Ann Gastroenterol. 2024 Jul-Aug;37(4):436-441. doi: 10.20524/aog.2024.0892. Epub 2024 Jun 14.
Crohn's disease (CD) and ulcerative colitis (UC) are the 2 main types of inflammatory bowel disease (IBD), a chronic inflammatory condition of the gastrointestinal tract. Management of IBD necessitates frequent clinical monitoring, including blood tests and occasionally endoscopy. Fecal calprotectin (FC) is a non-invasive measurement of luminal inflammatory activity, and can therefore be used as a useful monitoring tool. This study aimed to assess the relationship between FC, IBD activity indices and the commonly used blood markers in pediatric IBD.
Electronic patient records were accessed to retrospectively collect patient data from a tertiary pediatric hospital from 2015-2021. CD and UC disease activity was quantified using the Pediatric CD Activity Index (PCDAI) and Pediatric UC Activity Index (PUCAI), respectively. The Paris classification was used for phenotype identification.
A total of 208 patients were included in the study, 115 with CD (18% <10 years and 82% 10-17 years) and 93 with UC (32% <10 years and 68% 10-17 years). There was a positive correlation between FC and PCDAI (r=0.546, P<0.001) and between FC and PUCAI (r=0.485, P<0.001). FC and activity indices were correlated positively with inflammatory markers/platelets and negatively with albumin and hemoglobin. FC correlated positively with PCDAI in all CD phenotypes, including isolated ileal disease.
In pediatric IBD, FC shows a positive correlation with the clinical picture and blood markers in all disease phenotypes, and can provide an accurate non-invasive measure of disease activity.
克罗恩病（CD）和溃疡性结肠炎（UC）是炎症性肠病（IBD）的两种主要类型，IBD是一种胃肠道的慢性炎症性疾病。IBD的管理需要频繁的临床监测，包括血液检查以及偶尔的内镜检查。粪便钙卫蛋白（FC）是对管腔内炎症活动的一种非侵入性测量，因此可作为一种有用的监测工具。本研究旨在评估FC、IBD活动指数与儿科IBD中常用血液标志物之间的关系。
访问电子病历以回顾性收集2015年至2021年一家三级儿科医院的患者数据。分别使用儿科CD活动指数（PCDAI）和儿科UC活动指数（PUCAI）对CD和UC疾病活动进行量化。采用巴黎分类法进行表型鉴定。
本研究共纳入208例患者，其中115例为CD（18%年龄<10岁，82%年龄为10 - 17岁），93例为UC（32%年龄<10岁，68%年龄为10 - 17岁）。FC与PCDAI之间存在正相关（r = 0.546，P < 0.001），FC与PUCAI之间也存在正相关（r = 0.485，P < 0.001）。FC和活动指数与炎症标志物/血小板呈正相关，与白蛋白和血红蛋白呈负相关。在所有CD表型中，包括孤立性回肠疾病，FC与PCDAI均呈正相关。
在儿科IBD中，FC在所有疾病表型中均与临床表现和血液标志物呈正相关，并且可以提供一种准确的疾病活动非侵入性测量方法。
