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Fecal calprotectin: a marker for clinical differentiation of microscopic colitis and irritable bowel syndrome

Authors von Arnim U, Wex T, Ganzert C, Schulz C, Malfertheiner P

Received 6 October 2015

Accepted for publication 14 December 2015

Published 21 April 2016 Volume 2016:9 Pages 97—103

DOI https://doi.org/10.2147/CEG.S97701

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Yi Shen

Peer reviewer comments 4

Editor who approved publication: Professor Andreas M Kaiser


Ulrike von Arnim, Thomas Wex, Christine Ganzert, Christian Schulz, Peter Malfertheiner
 
Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany

Background: The aim of this study is to compare two methods for measuring fecal calprotectin (FC) concentration and to evaluate the possibility of differentiation between microscopic colitis (MC) and irritable bowel syndrome (IBS).
Methods: Twenty-three patients with MC (six patients with active disease and 17 patients retested in remission) and 20 patients with IBS were prospectively included in this study. Active disease state of MC was determined by clinical symptoms of >3 bowel movements per day and histological correlate. All patients underwent ileocolonoscopy, including segmental biopsy samples for histology. FC levels in stool samples were analyzed using a rapid test system (Quantum Blue®) and an enzyme-linked immunosorbent assay (ELISA).
Results: FC levels were significantly higher in patients with active MC (median 48 µg/g [23–106]) compared to patients with IBS (median 2 µg/g [1–111.83]), P=0.0001 using an ELISA. FC level of patients with MC in remission was 22 µg/g (1–106.4), which is similar to those identified in patients with IBS. The difference of FC levels between active MC and IBS was not detected by the FC rapid test (P=0.635).
Discussion: FC levels might serve as parameter for differentiation between patients with active MC and IBS. Since there is no surrogate marker available at present for MC, FC appears to be a candidate for differentiating MC from IBS.
Conclusion: High FC levels, which were analyzed by ELISA, are a potential marker for patients with active MC compared to those with IBS. The FC rapid test was less suitable for this purpose.

Keywords: microscopic colitis, fecal calprotectin, irritable bowel syndrome, IBS, diarrhea, chronic diarrhea

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