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Fecal calprotectin as an alternative to ulcerative colitis endoscopic index of severity to predict the response to corticosteroids of acute severe ulcerative colitis: A prospective observational study.

AbstractBACKGROUND:
Fecal calprotectin (FC) might be an alternative to ulcerative colitis endoscopic index of severity (UCEIS) to predict the response to corticosteroids (CS) in acute severe colitis (ASC).
METHODS:
One hundred and seventeen ASC patients were prospectively enrolled. Demographic, clinical, laboratory and sigmoidoscopic data were documented. Multivariate and ROC analyses were performed to identify risk factors for non-response to CS, and the predictive accuracy of possible predictors was assessed.
RESULTS:
Totally, 39 (33.33%) patients failed intravenous CS therapy. CS responders among mild (UCEIS 3-4), moderate (UCEIS 5-6) and severe (UCEIS 7-8) groups were 40/44 (90.91%) vs. 36/55 (65.45%) vs. 2/18 (11.11%) (p<0.001). UCEIS (OR=5.08; 95% CI, 1.93-8.66; p<0.001) and FC (OR=2.56; 95% CI, 1.17-3.55; p=0.022) were found to be independent risk factors for CS non-responders. Compared with C-reactive protein, platelet, hemoglobin and albumin, baseline FC had the strongest correlation with UCEIS (r=0.701, p<0.001). ROC analysis of UCEIS and baseline FC in predicting CS non-response showed an AUC of 0.85 and 0.76 respectively.
CONCLUSIONS:
Baseline FC levels correlated significantly with UCEIS in ASC, and both were useful in predicting short-term outcome of CS treatment. Baseline FC levels could be used as an alternative of UCEIS to guide the decision of early salvage therapy or colectomy and reduce the adverse effects of long-term futile CS usage.
AuthorsTingbin Xie, Chenyan Zhao, Chao Ding, Tenghui Zhang, Xujie Dai, Tengfei Lv, Yi Li, Zhen Guo, Jianfeng Gong, Weiming Zhu
JournalDigestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 49 Issue 9 Pg. 984-990 (Sep 2017) ISSN: 1878-3562 [Electronic] Netherlands
PMID28539226 (Publication Type: Journal Article, Observational Study)
CopyrightCopyright © 2017. Published by Elsevier Ltd.
Chemical References
  • Adrenal Cortex Hormones
  • Leukocyte L1 Antigen Complex
Topics
  • Acute Disease
  • Adrenal Cortex Hormones (therapeutic use)
  • Adult
  • China
  • Colitis, Ulcerative (drug therapy)
  • Disease Management
  • Feces (chemistry)
  • Female
  • Humans
  • Leukocyte L1 Antigen Complex (analysis)
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Prospective Studies
  • ROC Curve
  • Risk Factors
  • Severity of Illness Index
  • Sigmoidoscopy

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