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Fecal calprotectin is a predictive marker of relapse in Crohn's disease involving the colon: a prospective study

Kallel, Lamiaa; Ayadi, Imenb; Matri, Samiraa; Fekih, Moniaa; Mahmoud, Nadia Bena; Feki, Moncefb; Karoui, Samia; Zouari, Bechirc; Boubaker, Jalela; Kaabachi, Nazihab; Filali, Azzaa

European Journal of Gastroenterology & Hepatology: March 2010 - Volume 22 - Issue 3 - p 340-345
doi: 10.1097/MEG.0b013e32832bab49
Original Articles: Inflammatory Bowel Disease

Objectives Fecal calprotectin seems to have a diagnostic precision in predicting relapse in quiescent ulcerative colitis patients. However, the data remain controversial in Crohn's disease. The aim of this study was to prospectively evaluate the role of fecal calprotectin as a predictive marker for 1-year follow-up in patients with asymptomatic Crohn's disease.

Methods Fifty-three Crohn's disease patients in clinical remission were consecutively included providing at the beginning of the study a single stool sample as well as a blood sample and regularly followed-up for 12 months. Fecal calprotectin level was measured using a commercially available enzyme-linked immunoassay.

Results Among 53 patients, 10 (18.9%) developed clinical relapse during the 12-month follow-up period. Median fecal calprotectin level was significantly higher in relapse group patients compared with that in nonrelapse group (380.5 vs. 155 μg/g, P<0.001). With a cutoff value of 340 μg/g fecal calprotectin gave sensitivity of 80% and specificity of 90.7% in predicting clinical relapse. Fecal calprotectin level greater that 340 μg/g gave an 18-fold higher risk to develop relapse (log rank P<0.001) and was found to be an independent predictive factor of relapse (P=0.02).

Conclusion Fecal calprotectin seems to be a reliable marker of relapse in quiescent Crohn's disease patients.

aDepartment of Gastroenterology A

bLaboratory of Biochemistry, Rabta Hospital

cDepartment of Statistics, Medical University, Tunis, Tunisia

Correspondence to Lamia Kallel, Department of Gastroenterology A, Rabta Hospital, Jabbari 1007, Tunis, Tunisia

Tel: +216 98 33 39 37; e-mail:

Received 17 January 2009 Accepted 16 March 2009

© 2010 Lippincott Williams & Wilkins, Inc.