Paediatrics

The 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.

Due 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.

Haemoglobin 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.

Based 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.

FC 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.

Using 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.

These 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.

FC 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.

In this pilot study calprotectin decreased in patients who achieved clinical remission and may be useful to predict response to treatment.

Compared with healthy adults, newborns have high calprotectin concentrations in the first days of life. There is no obvious influence of the mode of feeding.

FC 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.

Compared 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.

The 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.

During the first weeks of life, the high f-calprotectin values observed in preterm infants could be linked to the gut bacterial establishment.

The 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.

A 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.

FC 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).

ADA 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

When treated with infliximab, fecal calprotectin levels reflecting intestinal inflammation normalized rapidly in one third of pediatric patients suggesting complete mucosal healing.

We present the first data showing that rapid assay FC levels are potentially useful in the bedside diagnosis of NEC.

While 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.

Among 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.

Fecal 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.

The SIGNEC U.K. conference represents an important first-step in providing an international platform for a focused discussion on NEC.

The 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.

An overview of; clinical presentation, prevention, staging, management, treatments, complications and prognosis, along with further reading.

Fecal calprotectin increases in infants with NEC and serial measurements may be useful as a noninvasive prognostic marker for progression of disease