Saudi Journal of Gastroenterology
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ORIGINAL ARTICLE
Year : 2015  |  Volume : 21  |  Issue : 6  |  Page : 360-366

Rapid fecal calprotectin testing to assess for endoscopic disease activity in inflammatory bowel disease: A diagnostic cohort study


1 Department of Medicine, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada
2 Department of Medicine, London Health Sciences Centre, University of Western Ontario, London, Ontario; Department of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
3 Department of Pediatrics, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada
4 Department of Medicine, London Health Sciences Centre, University of Western Ontario, London, Ontario; Department of Pediatrics, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada
5 Department of Microbiology, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

Correspondence Address:
Dr. Mahmoud Mosli
Department of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-3767.170948

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Background and Aim: With increasing numbers of patients diagnosed with inflammatory bowel disease (IBD), it is important to identify noninvasive methods of detecting disease activity. The aim of this study is to examine the diagnostic accuracy of fecal rapid calprotectin (FC) testing in the detection of endoscopically active IBD. Patients and Methods: All consecutive patients presenting to outpatient clinics with lower gastrointestinal symptoms were prospectively recruited. Patients provided FC samples. Sensitivity (Sn), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) for FC were calculated. Receiver–operator characteristics (ROC) curve was used to identify the ideal FC cutoff that predicts endoscopic disease activity. Correlation between FC and endoscopic disease activity, disease location, and C-reactive protein (CRP) levels were measured. Results: One hundred and twenty-six patients, of whom 52% were females, were included in the final analysis with a mean age of 44.4 ± 16.7 years. Comparing FC to endoscopic findings, the following results were calculated: A cutoff point of 100 μg/g showed Sn = 83%, Sp = 67%, PPV = 65%, and NPV = 85%; and 200 μg/g showed Sn = 66%, Sp = 82%, PPV = 73%, and NPV = 77%. Based on ROC curve, the best FC cutoff point to predict endoscopic disease activity was 140 μg/g. Using this reference, FC levels strongly correlated with colorectal, ileocolonic, and ileal disease and predicted endoscopic activity. Conclusions: FC is an accurate test when used as an initial screening tool for patients suspected of having active IBD. Given its noninvasive nature, it may prove to reduce the need for colonoscopy and be an added tool in the management of IBD.


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