Share Facebook
Crohn's Disease Forum » Books, Multimedia, Research & News » Utility of faecal calprotectin in inflammatory bowel disease (IBD): what cut-offs should we apply?


12-06-2014, 11:35 PM   #1
DustyKat
Super Moderator
 
DustyKat's Avatar
 
Join Date: May 2010
Location: New South Wales, Australia
Utility of faecal calprotectin in inflammatory bowel disease (IBD): what cut-offs should we apply?

Abstract: Adult research that also includes the effects of timing and temperature on samples and comparisons of ELISA tests.

Background
Faecal calprotectin (FC), a cytosolic protein released by neutrophils (S100 family) in response to inflammation, is a simple, non-invasive test that can be used to differentiate irritable bowel syndrome (IBS) with inflammatory bowel disease (IBD), where there can be considerable symptom overlap.

Aims and methods
The aims of the study were (1) to be able to predict the ability of FC to exclude IBD and determine cut-offs when in remission, (2) to investigate the effects of time and temperature on stability of FC and (3) compare three ELISA kits to measure FC: Buhlmann, PhiCal v1 and PhiCal v2. A total of 311 patients with altered bowel habit were tested for FC; 144 with IBS, 148 with IBD and 19 with other organic causes.

Results
Sensitivity and specificity of FC (with PhiCal v2 kit) to distinguish between functional disorder (IBS) and IBD using cut-off 50 μg/g were 88% and 78%, respectively, with a negative predictive value of 87%. Area under the receiver operating curve was 0.84 (CI 0.78 to 0.90). For those with IBD, FC values below 250 μg/g corresponded with remission of disease with a sensitivity and specificity of 90% and 76%, respectively. Area under the receiver operating curve was 0.93 (CI 0.89 to 0.97). FC was stable once extracted and frozen for up to 2.5 months. Pearson correlation was good between Buhlmann assay and PhiCal v2 (r2 = 0.95).

Conclusions FC has up to 87% negative predictive value to exclude IBD, and cut-offs less than 250 μg/g had 90% sensitivity to determine remission in IBD. Once frozen, FC is stable and the ELISA monoclonal plates were broadly comparable.
Full Article:

http://fg.bmj.com/content/early/2014...13-100420.full
__________________
Mum of 2 kids with Crohn's.
12-06-2014, 11:41 PM   #2
DustyKat
Super Moderator
 
DustyKat's Avatar
 
Join Date: May 2010
Location: New South Wales, Australia
Matt has just had a review with the GI and I asked about FC as a marker of disease status in small bowel disease. His personal opinion, through his own research and observations, is that whilst large bowel disease (both UC and Crohn’s) produce reliable comparisons between FC and scopes in small bowel disease the marry up isn’t nearly as consistent.
12-07-2014, 12:30 AM   #3
Clash
Forum Monitor
 
Clash's Avatar
 
Join Date: Apr 2012
Location: Georgia

My Support Groups:
C's FC, colonoscopy and MRE married up nicely. But then the area during surgery didn't marry up to any of those results so it seems no matter the testing it can all be a guessing game.

For C, I do have to say that his FC has always seem to marry up to suspected flares but blood work never has.

Oh and I haven't found a situation yet to throw in the new phrase I picked up from you, "feral gallbladder", but I'm patiently waiting! Best new phrase I've hear in the last six months. The visual just makes me crack up!
__________________
Clash
Mom to
C age 19
dx March 2012 CD

CURRENT MEDS: MTX injections, Stelara


Dx May 2014: JSpA
8/2014 ileocecectomy
9/2017 G tube

PAST MEDS: remicade, oral mtx, humira
12-08-2014, 10:21 AM   #4
crohnsinct
Senior Member
 
Join Date: Mar 2012
Location: Connecticut

My Support Groups:
Bahaha! Me To Clash! I love that phrase and if anyone was going to have a feral gallbladder.....

Thanks for the research Dusty! You know I am all about the FC these days.

But quick question...when he says it doesn't necessarily marry up with small bowel disease...I am assuming he means a low value doesn't necessarily mean there is no disease. Not that a high value means likely colonic disease and not small bowel...right?
__________________
Daughter O dx 2/1/12 at age 12
Crohns & Remicade induced Psoriasis
Remicade
Methotrexate (12.5mg wkly - oral)
Vit d 2000IU
Multi vitamin plus iron
Calcium
Folic Acid
Previously used - Prednisone, Prevacid, Enteral Nutrition

Daughter T dx 1/2/15 at age 11
Vitaligo, Precoscious puberty & Crohns
Methotrexate (15mg weekly oral)
Enteral Nutrition
Entocort
IBD-AID Diet
Vit d 1000IU
Calcium
Folic Acid
Previously used: Mtx injections
12-13-2014, 03:37 PM   #5
DustyKat
Super Moderator
 
DustyKat's Avatar
 
Join Date: May 2010
Location: New South Wales, Australia
Hmmmm, quick with a question….

Sloooooooooow with a response!

Yes, a low value is not necessarily indicative of no active small bowel disease.

Dusty.
Reply

Crohn's Disease Forum » Books, Multimedia, Research & News » Utility of faecal calprotectin in inflammatory bowel disease (IBD): what cut-offs should we apply?
Thread Tools


All times are GMT -5. The time now is 03:54 PM.
Copyright 2006-2017 Crohnsforum.com