Publication

Predicting inflammatory bowel disease in children with abdominal pain and diarrhoea: calgranulin-C versus calprotectin stool tests

CACATU consortium, Jun-2018, In : Archives of Disease in Childhood. 103, 6, p. 565-571 7 p.

Research output: Contribution to journalArticleAcademicpeer-review

  • CACATU consortium

OBJECTIVE: Calgranulin-C (S100A12) is a new faecal marker of inflammation that is potentially more specific for inflammatory bowel disease (IBD) than calprotectin, since it is only released by activated granulocytes. We compared calgranulin-C and calprotectin to see which of the two tests best predicted IBD in children with chronic abdominal pain and diarrhoea.

DESIGN: Delayed-type cross-sectional diagnostic study.

SETTING AND PATIENTS: Previously undiagnosed patients aged 6-17 years, who were seen in paediatric clinics in the Netherlands and Belgium, sent in a stool sample for analysis. Patients with a high likelihood of IBD underwent upper and lower endoscopy (ie, preferred reference test), while those with a low likelihood were followed for 6 months for latent IBD to become visible (ie, alternative reference test). We used Bayesian modelling to correct for differential verification bias.

MAIN OUTCOME MEASURES: Primary outcome was the specificity for IBD using predefined test thresholds (calgranulin-C: 0.75 µg/g, calprotectin: 50 µg/g). Secondary outcome was the test accuracy with thresholds based on receiver operating characteristics (ROC) analysis.

RESULTS: IBD was diagnosed in 93 of 337 patients. Calgranulin-C had significantly better specificity than calprotectin when predefined thresholds were used (97% (95% credible interval (CI) 94% to 99%) vs 71% (95% CI 63% to 79%), respectively). When ROC-based thresholds were used (calgranulin-C: 0.75 µg/g, calprotectin: 400 µg/g), both tests performed equally well (specificity: 97% (95% CI 94% to 99%) vs 98% (95% CI 95% to 100%)).

CONCLUSIONS: Both calgranulin-C and calprotectin have excellent test characteristics to predict IBD and justify endoscopy.

TRIAL REGISTRATION NUMBER: NCT02197780.

Original languageEnglish
Pages (from-to)565-571
Number of pages7
JournalArchives of Disease in Childhood
Volume103
Issue number6
Publication statusPublished - Jun-2018

    Keywords

  • NONINVASIVE MARKER, S100A12, FECAL CALPROTECTIN, DIAGNOSTIC-ACCURACY

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