Specific Diseases

This validation of a pragmatic clinical care pathway demonstrates a safe and effective mechanism by which to use FC to monitor risk of disease activity in patients with Crohn’s disease established on therapy. It provides a framework for prioritising follow-up and for identifying patients at risk of continuing disease activity or those in whom therapy could be stepped down.

FC levels increased dynamically even with mild signs of intestinal inflammation. The rapid Quantum Blue® test presents a potential alternative to the time‑consuming ELISA, because its diagnostic accuracy is not influenced by disease location. It may be useful in the hospital setting, providing faster diagnosis and allowing cost reduction by lowering the number of endoscopic procedures.

Post-operative management strategies are associated with high cost, primarily medication related. Calprotectin use reduces costs. The long term cost-benefit of these strategies remains to be evaluated.

FC was the optimal fecal marker for monitoring disease activity in postoperative CD and was superior to CRP and CDAI. FL offered modest sensitivity for detecting recurrent disease, whereas S100A12 was sensitive but had low specificity and NPV.

A drop in FCAL <70% after induction predicts primary non-response to anti-TNFα in CD.

In this analysis of data from a prospective clinical trial, FC measurement has sufficient sensitivity and NPV values to monitor for CD recurrence after intestinal resection. Its predictive value might be used to identify patients most likely to relapse. After treatment for recurrence, the FC level can be used to monitor response to treatment. It predicts which patients will have disease recurrence with greater accuracy than CRP level or CDAI score.

FC is an accurate marker of Crohn’s disease activity and predicts for relapse, thus providing the clinician time to optimise therapy. FC is a more sensitive marker of Crohn’s disease activity than CRP.

In this prospective dataset, FC is a useful tool to help identify quiescent Crohn’s disease patients at a low risk of relapse over the ensuing 12 months. FC of 240 μg/g was the optimal cutoff in this cohort.

A new rapid test for fecal calprotectin predicts endoscopic remission and postoperative recurrence in Crohn’s disease

The use of biomarkers as surrogate markers of intestinal and systemic inflammation might help. Two biomarkers have been most broadly assessed in Crohn’s disease: C-reactive protein and faecal calprotectin. These markers correlate significantly with endoscopic lesions, with the risk of relapse and with response to therapy. They could be used to help make decisions about diagnostic procedures and treatment.

Fecal calprotectin predict MH more accurately than CRP and the rest of biomarkers. The good correlation between ELISA and this quantitative rapid test enables us to use the rapid one in order to take fast and adequate decisions.

Levels and sensitivities of fCal are equal in patients with colonic and small bowel CD. Due to its high sensitivity and negative predictive value, fCal is a useful marker to rule out CD and select patients for endoscopy.

Long-term maintenance therapy with infliximab is required to maintain mucosal integrity in patients after surgery for Crohn’s disease. However, a dose of 3 mg/kg (a 40% reduction from the standard dose) was sufficient to avoid disease recurrence, determined by endoscopy, in all patients at 1 year. FC levels correlate with mucosal status at different infliximab doses.

For evaluation of Crohn’s disease activity, based on endoscopic findings, more sensitive surrogate markers than is CDAI or CRP are fecal calprotectin and lactoferrin. These prove to be useful tools for estimation of disease activity in Crohn’s disease.

The calprotectin method may be a useful adjuvant for discriminating between patients with Crohn’s disease and irritable bowel syndrome.

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.

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

Using a cut-off of 100 μg/g for normal values, the percentage agreement between the 2 tests was 87%. The optimal cut-off values to guide clinical decisions in the therapy of inflammatory bowel disease have yet to be determined.

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

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.

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

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.

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

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.

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