Can calprotectin predict relapse risk in inflammatory bowel disease?
OBJECTIVE
Assessing the clinical course of inflammatory bowel disease (IBD) patients consists of periodical clinical evaluations and laboratory tests. We aimed to assess the role of calprotectin tests in predicting clinical relapse in IBD patients.


METHODS
Ninety-seven patients with ulcerative colitis (UC) and 65 with Crohn's disease (CD) in clinical remission were prospectively included in the study. A 10-g stool sample was collected for calprotectin assay. The cutoff level was set at 130 mg/kg of feces. Patients were followed up for 1 yr after the test or until relapse. The cumulative proportion of relapses was estimated by the Kaplan-Meier analysis. Statistics for equality of survival distribution were tested using the log-rank test.


RESULTS
The calprotectin test was positive in 44 UC patients and 26 of them relapsed within a year, while 11 of 53 UC patients with a negative calprotectin test relapsed within the same time frame. Thirty CD patients had a positive calprotectin test and 13 of them relapsed within a year, as did 7 of the 35 with a negative test result. A significant correlation emerged between a positive calprotectin test and the probability of relapse in UC patients (P= 0.000). In CD patients, only cases of colonic CD showed a significant correlation between a positive calprotectin test and the probability of relapse, i.e., 6 colonic CD patients were positive for the calprotectin test and 4 relapsed (P= 0.02).


CONCLUSIONS
Measuring calprotectin may help to identify UC and colonic CD patients at higher risk of clinical relapse.
D'Incà
Renata
R
Department of Surgical and Gastroenterological Sciences, University of Padua, Padua, Italy.
Dal Pont
Elisabetta
E
Di Leo
Vincenza
V
Benazzato
Luca
L
Martinato
Matteo
M
Lamboglia
Francesca
F
Oliva
Lydia
L
Sturniolo
Giacomo Carlo
GC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000378:metabolism* / Q000628:therapy; D003424:Crohn Disease / Q000175:diagnosis* / Q000378:metabolism* / Q000628:therapy; D018572:Disease-Free Survival; D005243:Feces / Q000737:chemistry; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D039841:Leukocyte L1 Antigen Complex / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence
D039841:Leukocyte L1 Antigen Complex