Fecal calprotectin and lactoferrin as noninvasive markers of pediatric inflammatory bowel disease.
OBJECTIVE
To evaluate whether fecal calprotectin (FC) and fecal lactoferrin (FL) can be used as noninvasive markers in children and young people (4-17 years) with active inflammatory bowel disease (IBD).


METHODS
Stool samples were collected from 3 groups of children: those with active IBD, control individuals with other gastrointestinal (GI) diseases (GI control) and control individuals with no GI disease (non-GI control). The number of patients for the FC assay was as follows: IBD = 26, GI control = 30, non-GI control = 25. The number of patients for the FL assay was as follows: IBD = 24, GI control = 26, non-GI = 24. FC and FL were measured by use of enzyme-linked immunoassays.


RESULTS
The median concentrations of FC and FL in isolation, and their interaction, were significantly higher in the IBD group than in the GI and non-GI control groups (P < 0.001). Although the area under the curve, sensitivity, and specificity for FC, FL, and FC x FL interaction were significantly better than chance, FL consistently had the lowest area under the curve, and FC x FL consistently had the highest area under the curve.


CONCLUSIONS
FC and FL are both significantly elevated in children with IBD, and the interaction of these 2 biomarkers may produce a better initial diagnostic test compared with their use in isolation.
Joishy
Manohara
M
Department of Paediatric Gastroenterology, University Hospital of Wales, Cardiff, UK. arpijois@yahoo.co.uk
Davies
Ieuan
I
Ahmed
Mansoor
M
Wassel
Julie
J
Davies
Karen
K
Sayers
Adrian
A
Jenkins
Huw
H
D000293:Adolescent; D015415:Biomarkers / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D005243:Feces / Q000737:chemistry*; D005767:Gastrointestinal Diseases / Q000378:metabolism; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000378:metabolism; D007781:Lactoferrin / Q000032:analysis*; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D016015:Logistic Models; D012016:Reference Values
D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex; D007781:Lactoferrin