Inflammatory Bowel Diseases

Skip Navigation LinksHome > February 2013 - Volume 19 - Issue 2 > Fecal Calprotectin More Accurately Reflects Endoscopic Activ...
Inflammatory Bowel Diseases:
doi: 10.1097/MIB.0b013e3182810066
Original Clinical Articles

Fecal Calprotectin More Accurately Reflects Endoscopic Activity of Ulcerative Colitis than the Lichtiger Index, C-reactive Protein, Platelets, Hemoglobin, and Blood Leukocytes

Schoepfer, Alain M. MD1; Beglinger, Christoph MD2; Straumann, Alex MD2; Safroneeva, Ekaterina PhD3; Romero, Yvonne MD4,5,6; Armstrong, David MD7; Schmidt, Carsten MD8; Trummler, Michael MD9; Pittet, Valérie PhD10; Vavricka, Stephan R. MD11

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Abstract

Background: The correlation between noninvasive markers with endoscopic activity according to the modified Baron Index in patients with ulcerative colitis (UC) is unknown. We aimed to evaluate the correlation between endoscopic activity and fecal calprotectin (FC), C-reactive protein (CRP), hemoglobin, platelets, blood leukocytes, and the Lichtiger Index (clinical score).

Methods: UC patients undergoing complete colonoscopy were prospectively enrolled and scored clinically and endoscopically. Samples from feces and blood were analyzed in UC patients and controls.

Results: We enrolled 228 UC patients and 52 healthy controls. Endoscopic disease activity correlated best with FC (Spearman's rank correlation coefficient r = 0.821), followed by the Lichtiger Index (r = 0.682), CRP (r = 0.556), platelets (r = 0.488), blood leukocytes (r = 0.401), and hemoglobin (r = −0.388). FC was the only marker that could discriminate between different grades of endoscopic activity (grade 0, 16 [10–30] μg/g; grade 1, 35 [25–48] μg/g; grade 2, 102 [44–159] μg/g; grade 3, 235 [176–319] μg/g; grade 4, 611 [406–868] μg/g; P < 0.001 for discriminating the different grades). FC with a cutoff of 57 μg/g had a sensitivity of 91% and a specificity of 90% to detect endoscopically active disease (modified Baron Index ≥2).

Conclusions: FC correlated better with endoscopic disease activity than clinical activity, CRP, platelets, hemoglobin, and blood leukocytes. The strong correlation with endoscopic disease activity suggests that FC represents a useful biomarker for noninvasive monitoring of disease activity in UC patients.

© Crohn's & Colitis Foundation of America, Inc.

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