Fecal calprotectin is a good biomarker of mucosal healing in monitoring of children with IBD

Introduction. Fecal calprotectin (FC) concentrations of patients with inflammatory bowel diseases (IBD) are much higher than those of healthy controls or patients with functional disorders or other gastrointestinal diseases. Thus FC is a good biomarker of gut inflammation in differential diagnosis of IBD as well as mucosal healing in monitoring of IBD in adults. There is shortage of data concerning predictive value of FC in mucosa status assessment in children with IBD. Aim. The aim of the study was to assess the usefulness of FC as a biomarker of endoscopy proven mucosal healing in monitoring of children with IBD. Material and methods. 46 patients (25M, 21F; aged 13.7 ± 3.8) with IBD (24 ulcerative colitis – UC, and 22 Crohn’s disease – CD) were involved to the study and had elective colonoscopy performed and FC within a week before endoscopy measured. Mucosa status during endoscopy were assessed with SES-CD in case of CD and with Baron score in case of UC. Full mucosal healing was defined as SES-CD = 0 or Baron score = 0. The ROC curves was used as a statistical method to establish cut off points and AUC (area under curve) was regarded as assessment of discrimination between subgroup with full mucosal healing vs. subgroup with mucosal inflammation present. Results. The AUC was 0.95. The optimal cut-off level of discrimination between subgroup with full mucosal healing vs. subgroup with mucosal inflammation present was 233 μg/g with sensitivity 1 and specificity 0.79. When specificity was outweighed over sensitivity the cut-off point was 54 μg/g with sensitivity 0.77 and specificity 0.97. Conclusions. FC is a good biomarker of mucosal healing in monitoring of children with IBD. Values below 54 μg/g enable to select 77% patients with full mucosal healing.