The role of fecal calprotectin in diagnosing inflammatory bowel disease and detecting disease activity

Egyptian Liver Journal 2018, 8:136–142 Aim The aim of this study was to evaluate the role of fecal calprotectin (FC) in diagnosing and assessing inflammatory bowel disease (IBD) activity. Patients and methods Assessing FC allows for accurately distinguishing IBD from non-IBDs. A prospective case–control study was conducted on 80 patients divided into: IBD group (40 patients; 20 active IBD and 20 IBD in remission) and irritable bowel syndrome group (20 patients) in addition to healthy controls (20 participants). Informed written consent was obtained, and all the patients were subjected to complete history taking, clinical examination, laboratory investigations, abdominal ultrasound, total colonoscopy with biopsies, and measurement of FC levels. SPSS statistical package version was used. P values were nonsignificant if greater than or equal to 0.05, significant if less than 0.05, and highly significant if less than 0.01. Results The FC level was higher in the IBD group compared with IBS and control groups and higher in patients with active IBD compared with IBD in remission. There were significant positive correlations between FC and erythrocyte sedimentation rate, C-reactive protein level, and endoscopic extent in IBD patients. For the diagnosis of IBD, at an FC cutoff value of 69μg/g, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 87.5, 95, 97.2,79.2, and 90%, respectively. The best FC cutoff to detect disease activity was 148 μg/g, at which the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 100, 95, 95.2, 100, and 97.5%, respectively. Conclusion FC is a sensitive and noninvasive marker that can be used to differentiate IBD from irritable bowel syndrome and to detect IBD activity.