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The utility of a faecal calprotectin (FC) cut off >200 ug/g in a regional paediatric population
  1. A Casey1,
  2. S Lawrence1,
  3. P Henderson1,2,
  4. D Wilson1,2,
  5. P Gillett1,
  6. P Rodgers1
  1. 1Gastroenterology, Royal Hospital for Sick Children Edinburgh, NHS Lothian, Edinburgh, UK
  2. 2Child Life and Health, University of Edinburgh, Edinburgh, UK

Abstract

Introduction FC has previously been shown to be markedly raised in children and adults with IBD with its stability allowing the convenient collection of this non-invasive marker in both inpatient and outpatient settings.

Aims Firstly to evaluate all FC results performed in a regional paediatric hospital and analyse patient outcome, for the 6 years after the test became routinely available in our NHS health board on 01/01/05. Secondly, to evaluate our ‘clinical feel’ that a FC cut-off of 200 ug/g is warranted as a guide to the likelihood of chronic GI inflammation, especially IBD, at first presentation.

Method All FC sample results were collated from children seen in a regional paediatric hospital between 01/01/05 and 31/12/10 and were cross checked with all hospital and GI department records, giving patient outcome with a minimum of 10 months and a maximum of 82 months follow up. 2nd or subsequent FC results from the same patient and insufficient samples were excluded. We then specifically evaluated the cut off of 200 ug/g for ability to identify patients at risk of IBD.

Results 1010 FC samples were sent that met inclusion criteria. 205 were >200 ug/g, with 162 (79%) of these patients having GI endoscopy; 103 (50%) were diagnosed with IBD. None of the 102 patients with FC >200 ug/g not diagnosed with IBD have subsequently developed it. 805 patients had a FC <200 ug/g, of which 171 (21%) have had GI endoscopy. Only 4 (2%) of these patients having GI endoscopy were diagnosed with IBD, which equates to 0.5% of all patients with a FC<200 ug/g. 634 (79%) patients with a FC <200 did not require GI endoscopy and have not subsequently developed IBD.

Conclusion This is the first study looking at all FC results when routinely available in a regional paediatric hospital over a prolonged period. We have shown that only 0.5% of patients with a FC<200 ug/g but 50% of those >200 ug/g have been diagnosed with IBD, confirming the validity of a FC >200 ug/g cut off for IBD in our paediatric population.

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