Original articleAlimentary tractLevel of Fecal Calprotectin Correlates With Severity of Small Bowel Crohn’s Disease, Measured by Balloon-assisted Enteroscopy and Computed Tomography Enterography
Section snippets
Patients
Between May 2012 and July 2015, patients with a diagnosis of CD19 were enrolled into this prospective study at the Centre for Gastroenterology, Toho University Sakura Medical Centre. Patients who had very severe CD or needed immediate surgery were not included. The eligible patients (n = 89) underwent a total of 123 endoscopic examinations by BAE. Thirty-four of the 89 patients repeated endoscopy at a 6-month interval. In 82 patients, 100 BAE and CTE sessions were undertaken. From 70 patients
Patients’ Demographic Variables
A total of 89 patients, average age 31.8 years, were eligible for inclusion (Table 1). At the first endoscopy, the average CDAI was 120, range 0–401, and the average CRP was 1.09 mg/dL, range 0.01–9.13 mg/dL. Only 11 of the 89 patients (12.4%) were female. The average disease duration was 108 months. Twenty-seven patients (30.3%) had small bowel CD, 50 (56.2%) had ileocolonic CD, and 12 (13.5%) had colonic CD. Some patients had undergone multiple surgeries, which is common in CD patients
Discussion
We found that in patients with small bowel CD, the level of FC was well-correlated with the CD activity when the latter was defined by both BAE and CTE. Neither the CDAI score nor serum CRP showed similar correlation with FC regardless of CD location. Furthermore, CTE could reach and evaluate CD lesions in the small intestine unreachable by endoscopy. A good correlation between FC and the CTE findings should mean that both FC and CTE may define endoscopic mucosal healing.
At present, CRP is
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Updates in the diagnosis and management of small-bowel Crohn's disease
2023, Best Practice and Research: Clinical GastroenterologyBiomarkers of disease activity and other factors as predictors of adalimumab pharmacokinetics in inflammatory bowel disease
2020, European Journal of Pharmaceutical SciencesCitation Excerpt :On the other hand, there is controversy regarding the influence of the location of CD on the accuracy of the FCP to predict endoscopic lesions. While in some studies the accuracy is similar in different locations (Arai et al., 2016; Jensen et al., 2011), in most cases the correlation between FCP and endoscopic activity is lower in ileal disease than in colic or ileocolic (Lobatón et al., 2013; Stawczyk-Eder et al., 2015). Some authors have questioned the validity of these findings since the exploration of the ileum was performed by ileocolonoscopy and was considered incomplete since visualizing proximal small intestine sections was not possible (Guardiola et al., 2018).
Should We Divide Crohn's Disease Into Ileum-Dominant and Isolated Colonic Diseases?
2019, Clinical Gastroenterology and HepatologyCitation Excerpt :This discrepancy across cohorts when using capsule endoscopy as a gold standard may be a result of variation in correlation between FC and different small-bowel capsule endoscopic disease activity indices.72 When using cross-sectional imaging as a gold standard for disease activity, some studies have suggested an optimal cut-off value of approximately 150 ug/g for defining active ileal CD,73 whereas others have suggested a cut-off value of approximately 200 ug/g when using balloon-assisted enteroscopy with or without cross-sectional imaging as the gold standard.74,75 Thus, FC may correlate with ileal CD activity, but the optimal cut-off value has yet to be determined and is influenced significantly by the diagnostic tool and scoring index used as the gold standard.
Optimal Use of Serum Leucine-Rich Alpha-2 Glycoprotein as a Biomarker for Small Bowel Lesions of Crohn's Disease
2023, Inflammatory Intestinal Diseases
Conflicts of interest The authors disclose no conflicts.