The relation between elevated stool calprotectin and inflammatory bowel diseases

Abstract

Background: Inflammatory bowel disease (IBD) is a long-life disease with remission and relapse periods. IBD arises due to an inappropriate immune response and consequently causes inflammation and intestinal ulcers. Performing colonoscopy and inflamed bowel biopsy specimens for histopathological evaluation are currently considered the gold standard for diagnosing and managing IBD. These techniques are costly and invasive. In recent decades fecal calprotectin as a biomarker has received much attention for the diagnosis and non-invasive management of IBD. Aim: To assess the role of elevated fecal calprotectin as a prerequisite to suspect active and relapsed IBD.Method: Two hundred patients with endoscopic biopsy-proven IBD were enrolled in this study which was started in January 2021 to December 2023, all patients were negative for HBsAg, anti-HCV, HIV., negative Covid-19 PCR test, normal D-Dimer, normal CRP, normal coagulation profile (PT & INR). Result: Thirty patients (15%) with a diagnosis of UC (ulcerative colitis) at the time of presentation have high fecal calprotectin > 200 μg/g, and 30 patients (15%) with a diagnosis of UC at relapse have also high fecal calprotectin > 200 μg/g, the remaining 50 patients (25%) with a diagnosis of UC have normal fecal calprotectin < 50 μg/g. Twenty-five patients (12.5%) with a diagnosis of CD (Crohn´s disease) at the time of presentation have high fecal calprotectin > 200 μg/g, and 45 patients (22.5%) with a diagnosis of CD at relapse also have high fecal calprotectin > 200 μg/g, the remaining 20 patients (10%) with a diagnosis of CD have normal fecal calprotectin.Conclusion: Incorporating fecal calprotectin as a valuable noninvasive biomarker for managing IBD can significantly enhance patient care by providing timely and accurate information on disease activity and treatment response, an alternative to frequent endoscopies or imaging studies