Background & Aims: The routinely used clinical activity indices alongside systemic markers of inflammation as white blood count (WBC) and erythrocyte sedimentation rate (ESR), have low sensitivity and specificity in the discrimination between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). These limitations emphasize the need for a sensitive and specific non-invasive marker of bowel inflammation. The aim of the study was to evaluate fecal calprotectin (FC) and C-reactive protein (CRP) as biochemical markers in predicting IBD activity in patients with ulcerative colitis (UC).
Patients & Methods: The study included 50 patients with UC aged ranged from 12-74 years. All patients were subjected to full colonoscopy. Ileum was visualized. Each of 5 colonic segments was assessed using endoscopic component of the Mayo score. Colonic biopsies were taken from the suspected lesions for histopathological studies. Blood and stool samples were performed for both CRP and calprotectin respectively.
Results: Patients with mild activity had mean age 43.2, mean calprotectin 207.46, and mean C-reactive protein was 11.37. While in moderate to severe group, the mean age was 42.5, mean calprotectin 729.85 and mean CRP was 29.38. Fecal calprotectin (FC) cut off 47.5, sensitivity 84.6%, and specificity 54% and C-reactive protein cut off 7, sensitivity 84%, and specificity of 50% in prediction of moderate to severe activity of IBD.
Conclusions: Serial measurements of FC and CRP could be recommended for patients with UC to assess disease activity, induction and maintenance of remission, response to treatment, and recurrence of activity.