Study of cut-off level for Fecal Calprotectin and Its Relation to Endoscopic and Histological Remission in IBD Egyptian Patients

Document Type : Original Article

Authors

1 Department of Internal Medicine and Gastroenterology, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt

2 Department of Pathology, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt

Abstract

Background: Inflammatory bowel disease [IBD] poses diagnostic challenges. Fecal calprotectin [FCP] shows promise as a biomarker for intestinal inflammation and disease activity, but its optimal cut-off values and correlation with remission need further exploration in Egyptian patients
The aim of the work: The objective of this research was to investigate the optimal cut-off level for fecal calprotectin and its correlation with endoscopic and histological remission among Egyptian patients with inflammatory bowel disease [IBD].
Patients and Methods: A cross-sectional study was conducted with IBD patients from Menoufia University’s Endoscopy Unit. Retrospective data included demographics, clinical history, and laboratory results. Fecal calprotectin levels were measured using ELISA, and disease activity was evaluated using established scoring systems like the Mayo Endoscopic Score and modified Riley score.
Results: Analysis revealed that a fecal calprotectin [FC] threshold value of 164 mcg/g accurately predicted histologic remission [HR] based on the Nancy index. This threshold appeared to be indicative of overall endoscopic remission [ER] and histologic remission [HR] in UC patients, as determined by the Mayo clinical endoscopic Score [MES=0] and The Ulcerative Colitis Endoscopic Index of Severity [UCEIS≤1], with a sensitivity of 85.7%, specificity of 87.2%, and accuracy of 87%.
Conclusion:  In UC patients, a fecal calprotectin [FC] value below 164 mcg/g was found to effectively identify both endoscopic and histological remission, as evidenced by the Mayo clinical endoscopic Score [MES=0], The Ulcerative Colitis Endoscopic Index of Severity [UCEIS≤1], and the Nancy Index. Similarly, in CD patients, an FC value below 105 mcg/g was indicative of endoscopic remission as per the Simple Endoscopic Score for Crohn’s Disease [SES-CD≤2], while a value below 220 mcg/g identified histological remission based on the modified Riley score [mRS=0]   

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