title: Fecal calprotectin complements routine laboratory investigations in diagnosing childhood inflammatory bowel disease.
abstract: BACKGROUND
  We aimed to study fecal calprotectin in Scottish children with inflammatory bowel disease (IBD) and compare its diagnostic accuracy with blood parameters.
  
  
  METHODS
  Stool samples from 48 Scottish children (29 males, 19 females) had calprotectin measured at IBD diagnosis. The median age at diagnosis was 11.2 years (interquartile range [IQR] 8.7-13.0 years). There were 33 patients with Crohn's disease, 5 with ulcerative colitis, and 10 with IBD type unspecified. IBD was diagnosed by standard criteria. Calprotectin was measured using a commercially available kit (PhiCal Test) and 47/48 patients had comparative blood results available at diagnosis.
  
  
  RESULTS
  The fecal calprotectin concentrations were raised in 96% (46/48) of patients studied. The median calprotectin value was 750 microg/g (IQR 235.8-1251 microug/g). In comparison with standard blood tests, 32/45 (71.1%) had abnormal erythrocyte sedimentation rate, 19/38 (50.0%) had abnormal C-reactive protein, 29/46 (63.0%) had raised platelets, 12/45 (26.7%) had hypoalbuminemia, and 38/46 (82.6%) had abnormal hemoglobin. We identified 7/47 (14.9%) patients with raised calprotectin at diagnosis who did not have any abnormalities detected in the blood tests performed. All 48 patients (100%) had at least 1 abnormal blood test and/or raised calprotectin at diagnosis.
  
  
  CONCLUSIONS
  Calprotectin is significantly more likely to be raised than any commonly employed blood tests at IBD diagnosis. When used in combination with these bloods tests an abnormality was demonstrated in 1 or both tests in all patients at diagnosis in this study. Fecal calprotectin measurement is a significant advance when used contemporaneously and in addition to a routine panel of blood tests in the diagnosis of pediatric IBD.
authors.affiliation: Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Sick Children, Edinburgh, UK.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Quail
authors.forename: Richard K
authors.initials: RK
authors.lastname: Russell
authors.forename: Johan E
authors.initials: JE
authors.lastname: Van Limbergen
authors.forename: Pam
authors.initials: P
authors.lastname: Rogers
authors.forename: Hazel E
authors.initials: HE
authors.lastname: Drummond
authors.forename: David C
authors.initials: DC
authors.lastname: Wilson
authors.forename: Peter M
authors.initials: PM
authors.lastname: Gillett
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000032:analysis*; D002648:Child; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000378:metabolism; D003424:Crohn Disease / Q000175:diagnosis* / Q000378:metabolism; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D008297:Male; D011379:Prognosis
chemical_list: D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex