Document Detail

Fecal Level of Calprotectin Identifies Histologic Inflammation in Patients with Ulcerative Colitis In Clinical And Endoscopic Remission.
MedLine Citation:
PMID:  24993368     Owner:  NLM     Status:  Publisher    
BACKGROUND & AIMS:: Histologic recovery of patients with ulcerative colitis (UC) is often incomplete, even among those in clinical and endoscopic remission. Persistent active microscopic inflammation is associated with an increased risk of relapse and colorectal neoplasia. A high level of fecal calprotectin (FC) is a reliable marker of endoscopic lesions in patients with UC. We evaluated the accuracy of FC in identifying patients with UC in clinical and endoscopic remission who still have histologic features of inflammation.
METHODS: We performed a prospective observational study of 59 patients with UC in clinical and endoscopic remission undergoing colonoscopy. Several biopsy specimens were collected from each colonic segment. Endoscopic remission was defined as a Mayo endoscopic subscore grades of 0 or 1. Active histologic inflammation was defined by the presence of neutrophils infiltrating crypt epithelial cells. FC was determined by ELISA analysis.
RESULTS: Eighteen patients (30.5%) showed evidence of active histologic inflammation. Patients with active histologic inflammation had a significantly higher median level of FC (278 μg/g; interquartile range, 136-696 μg/g) than those without active histologic inflammation (68 μg/g; interquartile range, 30-172 μg/g) (P=.002). In multivariate analysis, FC and Mayo endoscopic subscore (0 or 1) were each independent predictors of histologic inflammation. Level of FC identified active histologic inflammation in patients in clinical and endoscopic remission with an area under the receiver operator characteristic curve value of 0.754.
CONCLUSIONS: Histologic inflammation is common among patients with UC in clinical and endoscopic remission. Patients with histologic features of inflammation can be reliably identified based on fecal level of calprotectin.
Jordi Guardiola; Triana Lobatón; Lorena Rodríguez-Alonso; Alexandra Ruiz-Cerulla; Claudia Arajol; Carolina Loayza; Xavier Sanjuan; Elena Sánchez; Francisco Rodríguez-Moranta
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-30
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  -     ISSN:  1542-7714     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-7-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.
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