Fecal Calprotectin as a Useful Non-Invasive Screening Marker for Eosinophilic Gastrointestinal Disorder in Korean Children.

Abstract

BACKGROUND:

Eosinophilic gastrointestinal disorder (EoGID) is an emerging disease condition in Korean children, but its diagnosis requires invasive endoscopic biopsies. Fecal calprotectin (FCal) is a noninvasive biomarker for intestinal inflammation to differentiate organic gastrointestinal diseases from functional abdominal pain disorder. This study aimed to evaluate the diagnostic accuracy of FCal and to determine the optimal cutoff to differentiate EoGID from functional abdominal pain disorder.

METHODS:

A total of 253 children (122 boys, 131 girls; mean age 12.2 ± 3.6, range 2.9-17.8 years) who underwent endoscopy with biopsies for chronic gastrointestinal symptoms were recruited, except for 38 children diagnosed with inflammatory bowel disease, and divided into EoGID (n = 67) and functional abdominal pain disorder (n = 186). FCal, white blood cell (WBC) counts, eosinophil counts, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels were measured in all subjects at initial diagnosis.

RESULTS:

FCal levels weakly correlated with WBC (r = 0.127, P = 0.044) and CRP (r = 0.126, P = 0.040) but not with ESR and eosinophil count. FCal levels were significantly higher in the EoGID group than in the functional abdominal pain disorder group (mean 179.5 ± 242.9 mg/kg vs. 44.3 ± 68.1 mg/kg; P < 0.001), while WBC, ESR, CRP, and eosinophil count did not differ between the two groups (all P > 0.05). An optimal cutoff of FCal 73.2 mg/kg distinguished EoGID from functional abdominal pain disorder with a sensitivity of 50.7% and a specificity of 84.6%.

CONCLUSION:

FCal is a useful and reliable noninvasive marker for differentiating EoGID from functional abdominal pain disorder in Korean children with chronic gastrointestinal symptoms when optimal cutoffs are applied.

• Authors: In Hyuk Yoo, Jin Min Cho, Jung Yeon Joo, Hye Ran Yang
• Journal: Journal of Korean medical science (J Korean Med Sci) Vol. 35 Issue 17 Pg. e120 (May 04 2020) ISSN: 1598-6357 [Electronic] Korea (South)
• PMID: 32356420 (Publication Type: Journal Article)
• Copyright: © 2020 The Korean Academy of Medical Sciences.

Chemical References

• Biomarkers
• Leukocyte L1 Antigen Complex
• C-Reactive Protein

Topics

• Abdominal Pain (etiology)
• Adolescent
• Area Under Curve
• Biomarkers (analysis)
• C-Reactive Protein (analysis)
• Child
• Child, Preschool
• Eosinophils (cytology)
• Feces (chemistry)
• Female
• Humans
• Inflammatory Bowel Diseases (complications, diagnosis)
• Intestinal Mucosa (pathology)
• Leukocyte Count
• Leukocyte L1 Antigen Complex (analysis)
• Male
• ROC Curve
• Republic of Korea
• Retrospective Studies
• Sensitivity and Specificity