Fecal calprotectin mirrors inflammation of the distal ileum and bowel function after restorative proctocolectomy for pediatric-onset ulcerative colitis
✍ Scribed by Mikko P. Pakarinen; Antti Koivusalo; Johanna Natunen; Merja Ashorn; Riitta Karikoski; Petri Aitola; Risto J. Rintala; Kaija-Leena Kolho
- Publisher
- John Wiley and Sons
- Year
- 2010
- Tongue
- English
- Weight
- 82 KB
- Volume
- 16
- Category
- Article
- ISSN
- 1078-0998
No coin nor oath required. For personal study only.
✦ Synopsis
Background:
The goal was to cross-sectionally assess fecal calprotectin after restorative proctocolectomy for pediatric-onset ulcerative colitis (uc).
Methods:
Fecal calprotectin, histology of the distal ileum, inflammation biochemistry, episodes of pouchitis, and bowel function were cross-sectionally determined at early adulthood in 32 patients who had undergone proctocolectomy with ileoanal anastomosis for uc at a mean (sd) age of 12.0 +/- 4.1 years.
Results:
A total of 15 (47%) patients showed increased (>100 microg/g) fecal calprotectin (669 +/- 866 microg/g), although their serum c-reactive protein (5.2 +/- 3.8 mg/l), erythrocyte sedimentation rate (13 +/- 13 mm/h), and white blood cell count (6.7 +/- 1.7 e9/l) were normal or slightly elevated. calprotectin correlated positively with the histological neutrophil count of the distal ileum (r = 0.715; p < 0.001), the frequency of pouchitis (r = 0.468; p < 0.01), and with the maximum daily frequency of bowel actions (r = 0.610; p < 0.001). mean fecal calprotectin was 71 +/- 50 microg/g among patients with no history of pouchitis (n = 10), 290 +/- 131 microg/g among patients with a single episode of pouchitis (n = 15), and 832 +/- 422 microg/g among those with recurrent pouchitis (p = 0.019 between recurrent pouchitis and no pouchitis). sensitivity, specificity, positive predictive value, and negative predictive value for fecal calprotectin concentration over 300 microg/g to detect recurrent pouchitis were 57%, 92%, 67%, and 89%, respectively.
Conclusions:
Neutrophilic inflammation of the distal ileum, as reflected by fecal calprotectin, is common after restorative proctocolectomy for pediatric-onset uc.