title: Fecal calprotectin concentration is increased in children with celiac disease: relation with histopathological findings.
abstract: OBJECTIVE
  The aim of this study was to compare the fecal calprotectin concentration in children with newly diagnosed celiac disease, children with celiac disease strictly adhering to a gluten-free diet and healthy controls. We also tried to correlate the fecal calprotectin concentration with the clinical presentation, degree of neutrophilic infiltration and the severity of histopathological injury (Marsh grade) in the small bowel mucosa.
  
  
  METHODS
  The study included three groups: children with untreated celiac disease, children with treated celiac disease, and healthy controls. Moreover, we obtained a second fecal sample from nine newly diagnosed children when their endomysial antibody became negative after gluten-free diet.
  
  
  RESULTS
  Fecal calprotectin concentrations were significantly higher in newly diagnosed celiac patients (n=31) compared to patients on gluten-free diet (n=33) and healthy controls (n=34) (117.2 μg/g (3.2-306) vs. 3.7 μg/g (0.5-58.2) and 9.6 μg/g (1-70), respectively, p<0.001). Patients presenting with gastrointestinal symptoms had higher fecal calprotectin concentration compared to the patients presenting with nongastrointestinal symptoms [142.8 (12.2-306) vs. 79.7 (3.2-243.2) respectively, p=0.04]. Nine newly diagnosed patients gave a second fecal sample after starting gluten-free diet when endomysial antibody became negative. Their fecal calprotectin concentration had decreased from 113.7 μg/g (8.7-295.2) to 4.2 μg/g (0.5-20.7) (p<0.01).
  
  
  CONCLUSIONS
  Increased fecal calprotectin concentration can be used as a non-invasive marker that might aid in the diagnosis of celiac disease, especially in patients with gastrointestinal presentation. Fecal calprotectin concentration returns to normal on a strict gluten-free diet. Fecal calprotectin may be used as a marker of diet adherence and improvement in gastrointestinal inflammation in children with celiac disease. Additionally, it may be used for the differentiation of celiac disease from functional disorders of the gastrointestinal system.
authors.affiliation: GATA, Department of Pediatric Gastroenterology, Hepatology and Nutrition, Ankara, Turkey. 20011975@mynet.com
authors.forename: Necati
authors.initials: N
authors.lastname: Balamtekın
authors.forename: Gökhan
authors.initials: G
authors.lastname: Baysoy
authors.forename: Nuray
authors.initials: N
authors.lastname: Uslu
authors.forename: Diclehan
authors.initials: D
authors.lastname: Orhan
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Akçören
authors.forename: Hasan
authors.initials: H
authors.lastname: Özen
authors.forename: Figen
authors.initials: F
authors.lastname: Gürakan
authors.forename: İnci Nur
authors.initials: İN
authors.lastname: Saltik-Temızel
authors.forename: Aysel
authors.initials: A
authors.lastname: Yüce
mesh_terms: D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis* / Q000378:metabolism; D002648:Child; D003937:Diagnosis, Differential; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D008297:Male; D012189:Retrospective Studies
chemical_list: D039841:Leukocyte L1 Antigen Complex