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THE USE OF FAECAL CALPROTECTIN IN PAEDIATRIC INFLAMMATORY BOWEL DISEASE
  1. J O'Gorman,
  2. S Hussey
  1. Department of Medicine, University of Glasgow, Glasgow, Scotland; Department of Gastroenterology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland

Abstract

Introduction Faecal calprotectin (FC) is an inflammatory marker that is raised in inflammatory bowel disease (IBD) and so can be used to determine which children require further investigation.

Aims/Background To evaluate the use of FC in children with possible IBD by establishing if the number of negative endoscopies had been minimised without missing any cases of IBD.

Method A retrospective analysis of FC measurements carried out from October 2011-September 2012. FC values were obtained from the biochemistry department. Following a computerised search of the departmental records the presenting complaint, endoscopy result if applicable, diagnosis of IBD or alternative diagnosis, and follow-up or discharge were recorded for each patient.

Results 36 patients (55%) were not scoped. All had at least one symptom indicative of IBD. 25 of these had a FC value of <50 µg/g. 4 of these patients had a FC result >200 µg/g. None of these patients have been diagnosed with IBD. 17 patients were scoped (26%). 3 were diagnosed with IBD. Median FC for the group that were not scoped was 30 µg/g (IQR 30–760 µg/g), compared with 126 µg/g (IQR 52–1590 µg/g) in the scoped group. 8 symptomatic patients with known IBD had a FC test and all values were consistent with GI inflammation. There was a 38% cost saving due to 44 unnecessary endoscopies being avoided.

Conclusion FC is a valuable test for excluding IBD in children who present with abdominal pain and diarrhoea; and confirming relapse in established disease. However, guidelines are required to ensure the appropriate use of this relatively new test.

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