Intest Res.  2016 Oct;14(4):305-313. 10.5217/ir.2016.14.4.305.

Accuracy of three different fecal calprotectin tests in the diagnosis of inflammatory bowel disease

Affiliations
  • 1Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. geniushee@yuhs.ac
  • 2Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND/AIMS
Several studies have found that the measurement of fecal calprotectin is useful for the early diagnosis of inflammatory bowel disease (IBD). We compared the effectiveness of three different fecal calprotectin kits for initial diagnosis in patients with suspected IBD.
METHODS
We enrolled 31 patients with IBD (18 Crohn's disease [CD], 11 ulcerative colitis [UC], and two intestinal Behçet's disease), five with irritable bowel syndrome (IBS), and five with other colitis (four infectious colitis and one intestinal tuberculosis). Diagnosis was based on clinical, laboratory, and endoscopic examinations. Fecal samples were obtained at the first diagnosis and calprotectin levels were measured using three different kits (Quantum Blue® Calprotectin, EliAâ„¢ Calprotectin, and RIDASCREEN® Calprotectin).
RESULTS
The overall accuracy for differentiating IBD from IBS or other colitis was 94% and 91%, respectively, for Quantum Blue® (cutoff, 50 µg/g); 92% and 89%, respectively, for EliAâ„¢ (cutoff, 50 µg/g); and 82% and 76%, respectively, for RIDASCREEN® (cutoff, 50 µg/g). In patients with CD, the results of Quantum Blue® Calprotectin and EliAâ„¢ Calprotectin correlated significantly with levels of the Crohn's disease activity index (Spearman's rank correlation coefficient, r=0.66 and r=0.49, respectively). In patients with UC, the results of EliAâ„¢ Calprotectin correlated significantly with the Mayo score (r=0.70).
CONCLUSIONS
Fecal calprotectin measurement is useful for the identification of IBD. The overall accuracies of the three fecal calprotectin kits are comparable.

Keyword

Fecal calprotectin; Inflammatory bowel disease; Irritable bowel syndrome

MeSH Terms

Colitis
Colitis, Ulcerative
Crohn Disease
Diagnosis*
Early Diagnosis
Humans
Inflammatory Bowel Diseases*
Irritable Bowel Syndrome
Leukocyte L1 Antigen Complex*
Leukocyte L1 Antigen Complex

Figure

  • Fig. 1 Selection of the study subjects.

  • Fig. 2 The comparison of methods using Spearman's rank correlation. (A) The correlation and trend line between Quantum Blue® and EliA™ assays (n=39, r=0.90, P<0.0001; 95% CI, 0.82−0.95). (B) The correlation and trend line between Quantum Blue® and RIDASCREEN® assays (n=36, r=0.72, P<0.0001; 95% CI, 0.52−0.85).

  • Fig. 3 Fecal calprotectin measured by the three fecal calprotectin kits in three groups of patients. Fecal calprotectin according to the three different kits was significantly elevated in IBD compared to IBS. Fecal calprotectin determined by the three kits was not different between IBS and the "other colitis" group (see the METHODS section for the definition).

  • Fig. 4 (A-C) Correlation of the disease activity index with fecal calprotectin levels in IBD. In patients with CD, Quantum Blue® Calprotectin and EliA™ Calprotectin correlated significantly with the levels of CDAI. In patients with UC, EliA™ Calprotectin correlated significantly with the Mayo score. r, Spearman's rank correlation coefficient.

  • Fig. 5 Correlation of fecal calprotectin levels with the disease location in IBD. Solid lines indicate the mean of each group and error bars represent one standard error. (A) CD. According to all three kits, fecal calprotectin levels were significantly higher for ileocolonic involvement than for ileal involvement (all P-values, 0.004). (B) UC. For all three kits, fecal calprotectin levels did not differ by disease location.


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