CC BY-NC-ND 4.0 · Journal of Coloproctology 2019; 39(02): 115-120
DOI: 10.1016/j.jcol.2018.10.012
Original Article

Fecal calprotectin role in diagnosis of ulcerative colitis and treatment follow-up

Papel da calprotectina fecal no diagnóstico de colite ulcerativa e no acompanhamento do tratamento
Mahsa Mahdipour
a  Guilan University of Medical Sciences (GUMS), Gastrointestinal and Liver Diseases Research Center (GLDRC), Rasht, Iran
,
Afshin Shafaghi
b  Guilan University of Medical Sciences (GUMS), GI Cancer Screening and Prevention Research Center (GCSPRC), Rasht, Iran
,
Fariborz Mansour-Ghanaei
a  Guilan University of Medical Sciences (GUMS), Gastrointestinal and Liver Diseases Research Center (GLDRC), Rasht, Iran
,
Amineh Hojati
c  Guilan University of Medical Sciences (GUMS), Caspian Digestive Diseases Research Center (CDDRC), Rasht, Iran
,
Farahnaz Joukar
c  Guilan University of Medical Sciences (GUMS), Caspian Digestive Diseases Research Center (CDDRC), Rasht, Iran
,
Sara Mavaddati
a  Guilan University of Medical Sciences (GUMS), Gastrointestinal and Liver Diseases Research Center (GLDRC), Rasht, Iran
› Author Affiliations

Abstract

Objective Ulcerative colitis usually affects the rectum and potentially can involve the whole colon. Noninvasive methods such as fecal calprotectin measurement may be considered as a reliable and inexpensive approach in assessing disease severity or treatment change strategy.

Methods In this retrospective cross-sectional study, records of 56 ulcerative colitis patients who hospitalized with exacerbation between May 2016 and April 2017 were assessed based on IBD Data Bank Software in Gastrointestinal and Liver Diseases and Research Center (GLDRC), Guilan province, Iran between. A questionnaire of demographic characteristics, clinical findings and fecal calprotectin level was completed. Montreal classification severity of ulcerative colitis and Mayo disease activity index were scored. Data were analyzed for descriptive and analytical analysis.

Results Fecal calprotectin was significantly different in terms of disease severity based on both Mayo score (p = 0.007) and Montreal classification (p = 0.001). In patients with mild symptoms, no increase in fecal calprotectin was observed, but in patients with moderate and severe elevations in fecal calprotectin levels was significant. Also, C-Reactive Protein surge was related to disease severity (p = 0.02). Furthermore, regression comparison among high-chance patients based on fecal calprotectin was significantly related to higher Erythrocyte Sedimentation Rate levels and smoking, p = 0.01 and p = 0.05, respectively.

Conclusion It seems fecal calprotectin levels are related to the disease severity. Non-invasive methods, such as fecal calprotectin assay, may seem to be an alternative to aggressive, costly and time-consuming methods, such as colonoscopy and biopsy, to reduce the suffering of patients and ultimately help improve the patients’ life quality.

Resumo

Objetivo A colite ulcerativa geralmente afeta o reto, podendo acometer todo o cólon. Métodos não invasivos, como a dosagem de calprotectina fecal, podem ser uma abordagem confiável e barata para a avaliação da gravidade da doença ou da estratégia de mudança de tratamento.

Métodos Neste estudo transversal retrospectivo, os registros de 56 pacientes com colite ulcerativa que foram hospitalizados devido a exacerbação entre maio de 2016 e abril de 2017 foram avaliados usando o software IBD Data Bank no Centro de Pesquisa e Doenças Gastrointestinais e Hepáticas (GLDRC), na província de Guilan, Irã. Foi aplicado um questionário de características demográficas, achados clínicos e nível de calprotectina fecal. Foram usados o escore de Mayo de atividade da doença e a classificação de Montreal da gravidade da colite ulcerativa. Os dados foram analisados de forma descritiva e analítica.

Resultados A calprotectina fecal apresentou diferença significativa em termos de gravidade da doença com base no escore de Mayo (p = 0,007) e na classificação de Montreal (p = 0,001). Em pacientes com sintomas leves, nenhum aumento na calprotectina fecal foi observado. Entretanto, em pacientes com sintomas moderados e severos, o aumento nos níveis de calprotectina fecal foi significativo. Além disso, o aumento nos níveis de proteína C reativa foi associado à gravidade da doença (p = 0,02). A análise da regressão entre pacientes considerados de alto risco com base na calprotectina fecal indicou uma associação significativa com níveis elevados da taxa de sedimentação de eritrócitos e tabagismo (p = 0,01 e p = 0,05, respectivamente).

Conclusão Os níveis de calprotectina fecal parecem estar relacionados com a gravidade da doença. Métodos não invasivos, como o estudo de calprotectina fecal, podem ser uma alternativa a métodos agressivos, caros e demorados, tais como colonoscopia e biópsia, reduzindo o sofrimento e ajudando a melhorar a qualidade de vida dos pacientes.



Publication History

Received: 10 September 2018

Accepted: 30 October 2018

Publication Date:
08 March 2021 (online)

© 2018. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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