An interview with Prof. Dr. Patrick van Rheenen, University Medical Center Groningen, The Netherlands
Prof. Dr. Patrick van Rheenen, University Medical Center GroningenAn interview with Prof. Dr. Patrick van Rheenen, University Medical Center Groningen, The Netherlands
Prof. Dr. Patrick van Rheenen, University Medical Center GroningenThe most prevalent food allergy in younger children is cow’s milk protein allergy (CMPA), and its most common clinical manifestation is allergic colitis. This study shows a significant decrease in FC levels and clinical symptoms when a strict elimination diet is adopted. Measuring FC levels to monitor the extent of intestinal inflammation caused by the allergen is proposed
Lendvai-Emmert et al. (2022) Frontiers in PediatricsAround 1 in 10 cases of inflammatory bowel disease (IBD) will present before adulthood, with the median age at presentation being 11–12 years.1 IBD in children and young people is associated with more extensive disease, increased disease activity and a higher rate of complications compared with adult-onset IBD.2Worldwide, estimates of paediatric IBD prevalence rates are lacking, but data suggest its incidence is increasing.3
United European Gastroenterology EducationIn our local population, faecal calprotectin varies with age. Children aged 1–3.9 years had higher concentrations of faecal calprotectin than adults, but there was no significant difference in faecal calprotectin between older children and adults.
Davidson, et al. (2017) Annals of Clinical BiochemistryThere was a statistically significant correlation between fecal calprotectin and gastritis and severity of H. pylori infection. Fecal calprotectin level measurement can avoid unnecessary endoscopies and is also useful for evaluation of therapy response.
Ataee et al. (2017) Iranian Journal of Pediatrics in PressThere was a strong correlation between the results obtained from the point of care test and the ELISA assay. FC point of care testing is a useful non-invasive screening tool in paediatric practice.
Shentova, et al. (2016) Merit Research Journal of Medicine and Medical SciencesAll three tests are very sensitive for detecting mucosal inflammation, but major differences exist between specificity and absolute values. It is highly advisable to use the test of the same manufacturer for follow-up and to monitor for disease activity.
Prell, et al. (2014). British Medical JournalAs a result, three cut-off levels were established based on the 97.5% percentiles of FC in different age groups: 538 mg/kg (1 < 6 months), 214 mg/kg (6 months < 3 years) and 75 mg/kg (3 < 4 years).
Oord, et al. (2014) Scandinavian Journal of GastroenterologyElevated levels of faecal calprotectin may indicate juvenile polyps in children. Examination with colonoscopy is still warranted in the pediatric population with elevated levels of faecal calprotectin.
Toth et al. (2009) UEGW/WCOG London, poster presentationCorrect use of the test can therefore contribute to reducing the number of unnecessary colonoscopies, which is especially important in children.
Jahnsen et al. (2008) The Journal of Norwegian Medical AssociationNo accumulation of calprotectin-rich leukocytes occurs in the healthy intestinal mucosa in the first months of life or later; therefore, the high calprotectin concentrations found, especially in some of the children in the youngest age groups, may reflect increased migration of neutrophil granulocytes into the gut lumen in early life.
Rugtveit, et al. (2002) Journal of Paediatric Gastroenterology and NutritionFecal calprotectin can be used to select patients who should undergo diagnostic colonoscopy for investigation of colorectal inflammation, including inflammatory bowel disease.
Fagerberg, et al. (2005) Journal of Paediatric Gastroenterology and NutritionThe findings of this prospective registry suggest that a quick response to conventional therapy predicts a favorable disease course in new-onset paediatric CD, but not in UC. The concept “time-to-reach target calprotectin level” rationalizes the indefinite term “response to treatment” and is well suited for studying treatment effectiveness in real-world practices.
Haisma, et al. (2019) Journal of Pediatric Gastroenterology and NutritionThe incorporation of noninvasive diagnostic tests into the initial diagnostic approach may avoid unnecessary invasive procedures and facilitate clinical decision-making when the diagnosis of IBD in children is initially uncertain.
Canani, et al. (2006) Journal of Paediatric Gastroenterology and NutritionDue to its lower-cost which makes its scale-up of use affordable, FOB could be immediately adopted as a monitoring tool for PC campaigns for efficacy evaluation before and after treatment.
Bustinduy, et al. (2013) PLOS Neglected Tropical DiseasesHome calprotectin tests were useful in guiding clinical management during a time when laboratory testing was less available. They may offer benefits as part of routine paediatric IBD monitoring to help target appointments and reduce unnecessary hospital attendances in the future.
Jere, et al. (2021) BMJ Open Gastroenterology Volume 8, Issue 1This prospective longitudinal pediatric study is the first to demonstrate that routine serial FC measurements are an independent valuable predictor of symptomatic relapse. Moreover, FC elevation was noted up to 3 months prior to the appearance of symptomatic relapse. Consequently, implementing a 3-monthly test to treat FC monitoring strategy would allow clinicians to make timely therapeutic adjustments in advance of disease relapse”. Uses BÜHLMANN fCAL® ELISA.
Foster, et al. (2019) World Journal GastroenterologyHaemoglobin and platelet count provide a useful screening test combination for patients with suspected IBD. These tests are not completely reliable however. If clinical suspicion is high further investigations are required.
Cabrera-Abreu, et al. (2004) Archive of Disease in ChildhoodBased on high FCal, the majority of children had treatment escalation that resulted in clinical improvement. FCal measurements were useful and reliable in decision-making and clinical care of children with IBD.
El-Matary, et al. (2017) Frontiers in PaediatricsFC 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.
Szczepański et al. (2014) Postępy Nauk MedycznychUsing a cutoff of 100 μg/g for normal values, the percentage agreement between the 2 tests was 87%. The optimal cutoff values to guide clinical decisions in the therapy of inflammatory bowel disease have yet to be determined.
Kolho et al. (2012) Journal of Paediatric Gastroenterology and NutritionThese guidelines are intended to give practical (whenever possible evidence-based) answers to (pediatric) gastroenterologists who take care of children and adolescents with CD; they are not meant to be a rule or legal standard, since many different clinical scenario exist requiring treatment strategies not covered by or different from these guidelines.
Ruemmele et al. 2014. Journal of Crohn’s and ColitisFC is a valuable test for excluding IBD in patients who present with abdominal pain and diarrhoea. When the test is used in these ways patients avoid an invasive procedure and the hospital is saved the cost of the endoscopy.
O’Gorman et al. (2013) Archives of Diseases in ChildhoodIn this pilot study calprotectin decreased in patients who achieved clinical remission and may be useful to predict response to treatment.
Gerasimidis et al. (2011) Journal of Clinical GastroenterologyCompared with healthy adults, newborns have high calprotectin concentrations in the first days of life. There is no obvious influence of the mode of feeding.
Campeotto, et al. (2003) Archive of Disease in ChildhoodFC levels may be a marker for early diagnosis and resolution of gastrointestinal illnesses in VLBW infants. Its utility for early diagnosis and assessment of resolution of NEC should be studied in a larger cohort of VLBW infants.
Yang, et al. (2008) NeonatologyCompared with adults and children, healthy full-term and preterm neonates have high calprotectin levels. The measurement of calprotectin levels in faeces can be a promising noninvasive clinical screening test for intestinal distress in neonates.
Kapel et al. (2010) Journal of Paediatric Gastroenterology and NutritionThe administration of L. reuteri DSM 17938 significantly decreases crying time and fecal calprotectin level. Colicky infants have significantly higher calprotectin levels than healthy controls. Finally, fecal calprotectin assay after probiotic treatment with L. reuteri DSM 17938 can be used to predict sustained clinical response and monitor gut health in infants.
Savino et al. (2015) PaediatricsDuring the first weeks of life, the high f-calprotectin values observed in preterm infants could be linked to the gut bacterial establishment.
Rouge et al. (2010) PLOS OneThe FC levels of children aged 1-18 months exhibit a downward trend with increasing age and are greater than the normal levels observed in healthy adults. In healthy children aged <6 months, FC levels are high. In children aged 6-18 months, FC concentrations are relatively low but are still higher than those of children aged >4 years.
Li et al. (2015) PLOS OneA total of 126 infants born at a median gestational age of 33 weeks (range 25.7–35 weeks) were enrolled. Samples (n = 312) were collected weekly from the end of the first week of life until the end of the first month and if any gastrointestinal event occurred.
Campeotto et al. (2009) Journal of Pediatric Gastroenterology and NutritionFC values found in this preliminary cohort of preterm neonates have been similar to those reported in the literature. The finding of a good correlation between the two techniques suggests the potential clinical usefulness of QuantumBlue at this age group (after validation).
Gonçalves et al. (2011) Paediatric ResearchADA has been shown to be effective in children with moderate-to-severe CD. Treatment benefits should be weighed against side effects. Multicenter longitudinal studies with longer follow-up periods are required to determine the true efficacy and safety of long-term ADA treatment
Navas-Lopez et al. (2013) Revista Española de Enfermedades DigestivasWhen treated with infliximab, fecal calprotectin levels reflecting intestinal inflammation normalized rapidly in one third of pediatric patients suggesting complete mucosal healing.
Hämäläinen, et al. (2011) World Journal of GastroenterologyWe present the first data showing that rapid assay FC levels are potentially useful in the bedside diagnosis of NEC.
Bin-Nun et al. (2015) American Journal of PerinatologyWhile researchers grapple with the various avenues for prevention, early diagnosis and treatment of NEC, parallel efforts are required to improve practice based on current evidence and to precisely delineate the intermediate and long-term impact of NEC.
Khashu et al. (2013) Stansted News Limited 2015, Infant SupplementAmong infants <33 weeks’ gestation, NEC appears to present at mean age of 7 days in more mature infants, whereas onset of NEC is delayed to 32 days of age in smaller, lower GA infants. Further studies are required to understand the etiology of this disease process.
Yee et al. (2011) PediatricsFecal calprotectin levels were significantly increased in premature infants with NEC. The fecal calprotectin test is a non-invasive, easy, and useful tool for the diagnosis of NEC.
Yoon et al. (2012) Korean Journal of PediatricsThe SIGNEC U.K. conference represents an important first-step in providing an international platform for a focused discussion on NEC.
Khashu et al. (2013) Stansted News Limited 2013, Infant SupplementThe separation of NEC from SIP (Gordon’s classification) and the subsequent reduction of NEC into subgroups (NEC reductionism) together represent an improved operational framework for more accurately assessing NEC incidence and origin.
Gordon et al. (2013). European Journal of Neonatal ResearchAn overview of; clinical presentation, prevention, staging, management, treatments, complications and prognosis, along with further reading.
Draper et al. (2011) PatientPlus OnlineFecal calprotectin increases in infants with NEC and serial measurements may be useful as a noninvasive prognostic marker for progression of disease
Aydemir et al. (2012) Journal of Maternity, fetal and neonatal medicine