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PTH-088 A faecal calprotectin level of >100 μg/g in patients with negative bi-directional endoscopies is associated with high yield of pathology detection by capsule endoscopy
  1. A Koulaouzidis1,
  2. S Douglas1,
  3. I Arnott2,
  4. J N Plevris1
  1. 1Centre of Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Scotland, UK
  2. 2Gastrointestinal Unit, Western General Hospital, Edinburgh, Scotland, UK

Abstract

Introduction Faecal calprotectin (FC) is a non-invasive marker of gastrointestinal inflammation with diagnostic precision in distinguishing inflammatory bowel disease (IBD) from non-IBD diagnoses; the higher precision is reported at a cut-off level of 100 μg/g. FC correlates with abnormalities seen on radiology of the small bowel, but little data exist in relation with capsule Endoscopy (SBCE).

Aims We aim to correlate the findings of SBCE with FC values in patients with clinical suspicion of Crohn's disease and negative bi-directional endoscopies.

Methods Patients who underwent SBCE due to suspicion of small bowel Crohn's were identified from the Rapid database. FC status was established for all review patients. Only patients with FC measured any time prior to the SBCE were included in the final review; in cases of multiple FC measurements, the value closest to the SBCE date was selected. Patients with prior known Crohn's or NSAIDs use were excluded.

Results A total of 45 patients were identified (32 females and 13 males). Two were excluded from further analysis as the capsules were retained in the upper GI tract. The remaining 43 cases, exhibited one or more of the following indications: Abdominal pain: 34, Loss of weight: 7, Diarrhoea: 21, High inflammation indices: 8 and anaemia/blood loss: 7. 18 patients had normal FC and 25 abnormal FC results. All those with FC<50 μg/g (normal reference range <50) and 7 patients who had FC between 50 and 100 μg/g, had normal SBCE. 18 patients had a FC >100 μg/g; of those 8 (44.5%) had findings suggestive of Crohn's disease. The patients (n=8) with SBCE indicative of Crohn's, had a mean FC levels of 367.12, range 115–1430 μg/g.

Conclusion FC>100 μg/g is a useful predictor of small bowel Crohn's findings by SBCE. FC levels <100 μg/g seem to have an excellent NPV. FC is a useful tool in prioritising patients with suspected Crohn's and increases the diagnostic yield of SBCE.

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