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Intestinal ultrasonography and fecal calprotectin for monitoring inflammation of ileal Crohn’s disease: two complementary tests

BACKGROUND/AIMS: Tight control of inflammation and adjustment of treatment if activity persists is the current strategy for the management of Crohn’s disease (CD). The usefulness of fecal calprotectin (FC) in isolated involvement of the small intestine in CD is controversial. To assess the usefulnes...

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Autores principales: Paredes, José María, Ripollés, Tomás, Algarra, Ángela, Diaz, Rafael, Moreno, Nadia, Latorre, Patricia, Martínez, María Jesús, Llopis, Pilar, López, Antonio, Moreno-Osset, Eduardo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Association for the Study of Intestinal Diseases 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9344237/
https://www.ncbi.nlm.nih.gov/pubmed/35279969
http://dx.doi.org/10.5217/ir.2021.00126
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author Paredes, José María
Ripollés, Tomás
Algarra, Ángela
Diaz, Rafael
Moreno, Nadia
Latorre, Patricia
Martínez, María Jesús
Llopis, Pilar
López, Antonio
Moreno-Osset, Eduardo
author_facet Paredes, José María
Ripollés, Tomás
Algarra, Ángela
Diaz, Rafael
Moreno, Nadia
Latorre, Patricia
Martínez, María Jesús
Llopis, Pilar
López, Antonio
Moreno-Osset, Eduardo
author_sort Paredes, José María
collection PubMed
description BACKGROUND/AIMS: Tight control of inflammation and adjustment of treatment if activity persists is the current strategy for the management of Crohn’s disease (CD). The usefulness of fecal calprotectin (FC) in isolated involvement of the small intestine in CD is controversial. To assess the usefulness of FC to determine the inflammatory activity detected by intestinal ultrasonography (IUS) in ileal CD. METHODS: Patients with exclusively ileal involvement CD who underwent IUS and an FC were prospectively included. Simple ultrasound index was used to determine inflammatory activity. The usual statistical tests for comparison of diagnostic techniques were used. RESULTS: One hundred and five patients were included, IUS showed inflammatory activity in 59% of patients and complications in 18.1%. FC showed a significant correlation with IUS in the weak range (Spearman coefficient r=0.502; P<0.001); the area under the receiver operating characteristic curve was 0.79 (95% confidence interval, 0.70–0.88; P<0.001). The FC value that best reflected the activity in IUS was 100 μg/g with sensitivity, specificity, and positive and negative predictive values of 73.0%, 71.4%, 79.3% and 63.8%, respectively. There were no differences in FC concentration between patients with or without transmural complications. The addition of serum C-reactive protein to FC did not improve the ability to assess IUS activity. CONCLUSIONS: FC has a significant correlation with IUS to monitor ileal CD activity. This correlation is weak and it does not allow assessing the presence of CD complications. Both tests should be used in conjunction for tight control of ileal CD. More studies on noninvasive tests in this location are needed.
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spelling pubmed-93442372022-08-02 Intestinal ultrasonography and fecal calprotectin for monitoring inflammation of ileal Crohn’s disease: two complementary tests Paredes, José María Ripollés, Tomás Algarra, Ángela Diaz, Rafael Moreno, Nadia Latorre, Patricia Martínez, María Jesús Llopis, Pilar López, Antonio Moreno-Osset, Eduardo Intest Res Original Article BACKGROUND/AIMS: Tight control of inflammation and adjustment of treatment if activity persists is the current strategy for the management of Crohn’s disease (CD). The usefulness of fecal calprotectin (FC) in isolated involvement of the small intestine in CD is controversial. To assess the usefulness of FC to determine the inflammatory activity detected by intestinal ultrasonography (IUS) in ileal CD. METHODS: Patients with exclusively ileal involvement CD who underwent IUS and an FC were prospectively included. Simple ultrasound index was used to determine inflammatory activity. The usual statistical tests for comparison of diagnostic techniques were used. RESULTS: One hundred and five patients were included, IUS showed inflammatory activity in 59% of patients and complications in 18.1%. FC showed a significant correlation with IUS in the weak range (Spearman coefficient r=0.502; P<0.001); the area under the receiver operating characteristic curve was 0.79 (95% confidence interval, 0.70–0.88; P<0.001). The FC value that best reflected the activity in IUS was 100 μg/g with sensitivity, specificity, and positive and negative predictive values of 73.0%, 71.4%, 79.3% and 63.8%, respectively. There were no differences in FC concentration between patients with or without transmural complications. The addition of serum C-reactive protein to FC did not improve the ability to assess IUS activity. CONCLUSIONS: FC has a significant correlation with IUS to monitor ileal CD activity. This correlation is weak and it does not allow assessing the presence of CD complications. Both tests should be used in conjunction for tight control of ileal CD. More studies on noninvasive tests in this location are needed. Korean Association for the Study of Intestinal Diseases 2022-07 2022-03-15 /pmc/articles/PMC9344237/ /pubmed/35279969 http://dx.doi.org/10.5217/ir.2021.00126 Text en © Copyright 2022. Korean Association for the Study of Intestinal Diseases. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Paredes, José María
Ripollés, Tomás
Algarra, Ángela
Diaz, Rafael
Moreno, Nadia
Latorre, Patricia
Martínez, María Jesús
Llopis, Pilar
López, Antonio
Moreno-Osset, Eduardo
Intestinal ultrasonography and fecal calprotectin for monitoring inflammation of ileal Crohn’s disease: two complementary tests
title Intestinal ultrasonography and fecal calprotectin for monitoring inflammation of ileal Crohn’s disease: two complementary tests
title_full Intestinal ultrasonography and fecal calprotectin for monitoring inflammation of ileal Crohn’s disease: two complementary tests
title_fullStr Intestinal ultrasonography and fecal calprotectin for monitoring inflammation of ileal Crohn’s disease: two complementary tests
title_full_unstemmed Intestinal ultrasonography and fecal calprotectin for monitoring inflammation of ileal Crohn’s disease: two complementary tests
title_short Intestinal ultrasonography and fecal calprotectin for monitoring inflammation of ileal Crohn’s disease: two complementary tests
title_sort intestinal ultrasonography and fecal calprotectin for monitoring inflammation of ileal crohn’s disease: two complementary tests
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9344237/
https://www.ncbi.nlm.nih.gov/pubmed/35279969
http://dx.doi.org/10.5217/ir.2021.00126
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