title: Can Fecal Calprotectin Level Be Used as a Markers of Inflammation in the Diagnosis and Follow-Up of Cow's Milk Protein Allergy?
abstract: OBJECTIVE
  Calprotectin is a cytosolic protein with immunomodulatory, antimicrobial, and antiproliferative actions. The concentration of calprotectin increases in infection, inflammation, and malignancy. We determined if calprotectin can be used as a marker for the diagnosis and follow-up of bowel inflammation in cow's milk protein allergy (CMPA).
  
  
  METHODS
  In total, 32 patients newly diagnosed with CMPA were included (24 IgE-mediated, 8 non-IgE-mediated). In all subjects, a complete blood count, total IgE, cow's milk-specific IgE, and fecal calprotectin (FC) were assessed before and after a cow's milk protein (CMP) elimination diet was started. The results were compared with those of 39 healthy children.
  
  
  RESULTS
  The mean FC value before the CMP elimination diet was 516±311 µg/g in the 32 patients with CMPA and 296±94 µg/g in the control group (P=0.011). The mean FC value after the diet in these patients was 254±169 µg/g, which was significantly different from the mean value before the CMP elimination diet (P<0.001). When we compared FC levels before the CMP elimination diet in the IgE-mediated group with the control group, we found no significant statistical difference (P=0.142). The mean FC value before the CMP elimination diet was 886±278 µg/g in the non-IgE-mediated group and 296±94 µg/g in the control group; this difference was statistically significant (P<0.001). In the IgE-mediated and non-IgE-mediated groups, FC values after CMP elimination diet were 218±90 µg/g and 359±288 µg/g, respectively, and FC values before CMP elimination diet were 392±209 µg/g and 886±278 µg/g, respectively; these differences were statistically significant (P=0.001 and P=0.025, respectively).
  
  
  CONCLUSIONS
  FC levels may be a useful marker for follow-up treatment and recurrence determination in CMPA.
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology and Nutrition, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Omer F
authors.initials: OF
authors.lastname: Beşer
authors.affiliation: Department of Pediatrics, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Sancak
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology and Nutrition, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Tülay
authors.initials: T
authors.lastname: Erkan
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology and Nutrition, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Tufan
authors.initials: T
authors.lastname: Kutlu
authors.affiliation: Department of Pediatric Allergy, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Haluk
authors.initials: H
authors.lastname: Cokuğraş
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology and Nutrition, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Fügen Ç
authors.initials: FÇ
authors.lastname: Cokuğraş
keywords: Milk hypersensitivity; fecal calprotectin; milk protein