Dolwani, S.; Wassell, J.; Metzner, M.; Losty, H.; Yong, A.; Lawrie, B.W.; Hawthorne, A.B.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA58
Academic Journal
Background/aims: The neutrophil derived protein Calprotectin has previously been found to be raised in intestinal inflammatory conditions. We aimed to evaluate the discriminant value of a stool calprotectin assay in predicting the likelihood of an abnormal result on a Barium follow through examination (BaFT) in patients being investigated for abdominal pain and or diarrhoea. Patients and Methods: Patients being investigated for abdominal pain and or diarrhoea and undergoing a BaFT as part of their workup (n=65) provided a one off stool sample for estimation of calprotectin level. This was compared with patients with known active Crohn's disease (positive controls), normal healthy volunteers & patients with irritable bowel syndrome (lBS) as negative controls. The biochemist performing the assay was blinded to all clinical details. Other clinical and laboratory indices such as ESR, CRP, and CDAI were assessed concomitantly. Results: The median level of calprotectin in the active Crohn's group (n=23) was 226.5 µg/g of stool compared to a median of 17.3 in the group with lBS (n=27) and 10.9 in normal healthy controls (n=24). A sensitivity of 94%, specificity of 68.7% & negative predictive value of 97% for the stool calprotectin assay. Of the 6 patients with IBD & a normal barium follow through, 5 had colonic Crohn's disease & 1 had ulcerative colitis on further investigation. Conclusion: Patients being investigated in a gastroenterology clinic for diarrhoea and or abdominal pain do not need small bowel radiology to rule out Crohn's disease if their stool calprotectin level is <60 µg/g.


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