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Br J Surg. 2009 Jun;96(6):663-74. doi: 10.1002/bjs.6593.

Faecal calprotectin or lactoferrin can identify postoperative recurrence in Crohn's disease.

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  • 1Department of Gastroenterology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, UK.

Abstract

BACKGROUND:

Identifying Crohn's disease recurrence in symptomatic patients after ileocaecal resection is difficult. The aim of this study was to evaluate faecal concentrations of granulocyte degradation products in this setting.

METHODS:

A postoperative cohort of 13 patients was followed prospectively for 1 year with regular faecal calprotectin (FC) and lactoferrin (FL) measurements. A second postoperative cohort (median 24 months after resection) of 104 patients provided a single stool sample. Faecal measurements were compared with symptom diaries, the Harvey Bradshaw Index, endoscopic examination, C-reactive protein and platelet measurement.

RESULTS:

In the uncomplicated course, both markers normalized within 2 months. Both FC and FL correlated significantly with Harvey Bradshaw Index (P < 0.001). Twenty-eight patients with severely clinically active disease had high mean(s.e.) levels of FC (661.1(119.1) microg/g) and FL (116.6(32.2) microg/g); and 43 with clinically inactive disease had low levels of FC (70.2(27.1) microg/g) and FL (5.9(2.4) microg/g). In patients with mild to moderately clinically active disease, FC and FL identified individuals with and without recurrent inflammatory disease. Faecal markers were more accurate at predicting clinical disease activity than C-reactive protein, platelet count or endoscopic appearance.

CONCLUSION:

FC and FL are non-invasive tests that can help to identify disease recurrence in symptomatic postoperative patients.

(c) 2009 British Journal of Surgery Society Ltd.

Comment in

PMID:
19384912
[PubMed - indexed for MEDLINE]
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