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Fecal Calprotectin in Pediatric Inflammatory Bowel Disease: A Systematic Review
Digestive Diseases and Sciences, 08/21/2012
Evidence Based Medicine
Clinical Article
Kostakis ID et al. – The fecal calprotectin test could be used for supporting diagnosis or confirming relapse of inflammatory bowel disease in pediatric patients. A positive result could confirm the suspicion of either inflammatory bowel disease diagnosis or inflammatory bowel disease relapse, due to the high sensitivity of the test, but a negative result should not exclude these conditions, due to its moderate specificity.
Methods- A search for articles published up to October 2011 was conducted using MEDLINE and EMBASE databases.
- The authors included original English-written articles referred to pediatric patients with inflammatory bowel disease and measured fecal calprotectin levels.
- They extracted data concerning fecal calprotectin levels in patients with inflammatory bowel disease and in the controls groups, sensitivity, specificity, positive and negative likelihood ratio.
- Thirty-four studies were included.
- Fecal calprotectin levels of patients with inflammatory bowel disease are much higher than those of healthy controls or patients with functional disorders or other gastrointestinal diseases.
- The results vary greatly when taking all studies into consideration.
- Nevertheless, in cases of newly diagnosed and/or active inflammatory bowel disease, the results are more homogeneous, with high sensitivity and positive likelihood ratio, low negative likelihood ratio, but moderate specificity.
- Moreover, 50 μg/g seems to be the most proper cut-off point for the fecal calprotectin test.