Fecal calprotectin and clinical disease activity in pediatric ulcerative colitis.

ISRN gastroenterology Pub Date : 2013-01-01 Epub Date: 2013-02-26 DOI:10.1155/2013/179024
Kaija-Leena Kolho, Dan Turner
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引用次数: 23

Abstract

Objective. To explore fecal calprotectin levels in pediatric ulcerative colitis (UC) in relation with the validated clinical activity index PUCAI. Methods. This study included all 37 children (median age 14 years) with UC who had calprotectin measured (PhiCal ELISA Test) by the time of PUCAI assessment at the Children's Hospital of Helsinki in a total of 62 visits. Calprotectin values <100  μ g/g of stool were considered as normal. The best cut-off value of each measure to predict 3-month clinical outcome was derived by maximizing sensitivity and specificity. Results. In clinically active disease (PUCAI ≥ 10), calprotectin was elevated in 29/32 patients (91% sensitivity). When in clinical remission, 26% (8/30) of the children had normal calprotectin but 7 (23%) had an exceedingly high level (>1000  μ g/g). The best cut-off value for calprotectin for predicting poor outcome was 800  μ g/g (sensitivity 73%, specificity 72%; area under the ROC curve being 0.71 (95%CI 0.57-0.85)) and for the PUCAI best cut-off values >10 (sensitivity 62%, specificity 64%; area under the ROC curve 0.714 (95%CI 0.58-0.85)). Conclusion. The clinical relevance of somewhat elevated calprotectin during clinical remission in pediatric UC is not known and, until further evidence accumulates, does not indicate therapy escalation.

Abstract Image

Abstract Image

儿童溃疡性结肠炎的粪便钙保护蛋白与临床疾病活动性。
目标。探讨小儿溃疡性结肠炎(UC)患者粪便钙保护蛋白水平与临床活性指数PUCAI的关系。方法。本研究纳入了所有37名UC患儿(中位年龄14岁),在赫尔辛基儿童医院进行PUCAI评估时进行了钙保护蛋白测定(物理ELISA试验),共62次就诊。钙保护素值1000 μ g/g)。钙保护蛋白预测不良预后的最佳临界值为800 μ g/g(敏感性73%,特异性72%;ROC曲线下面积为0.71 (95%CI 0.57 ~ 0.85), PUCAI最佳临界值>10(敏感性62%,特异性64%;ROC曲线下面积0.714 (95%CI 0.58-0.85)。结论。在儿童UC临床缓解期钙保护蛋白水平升高的临床相关性尚不清楚,在进一步的证据积累之前,并不表明治疗升级。
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