Study Backs Wider Use of Fecal Calprotectin in Pediatric IBD Workup

May 27, 2013

NEW YORK (Reuters Health) May 27 - Fecal calprotectin offers high sensitivity and modest specificity for diagnosing pediatric inflammatory bowel disease (IBD), according to a new systematic review and meta-analysis.

Although fecal calprotectin is commonly used to identify children with suspected bowel inflammation who warrant endoscopic evaluation, only recently has research shown that it outperforms other commonly used blood parameters with regard to diagnostic accuracy in pediatric IBD.

The new work, published online May 14 in The American Journal of Gastroenterology, includes 394 cases and 321 non-IBD controls from eight studies. That makes it the largest meta-analysis of its kind so far, note Dr. Paul Henderson from the University of Edinburgh and his co-authors.

The researchers found a pooled sensitivity of 97.8%, a pooled specificity of 68.2%, a positive likelihood ratio of 3.07, and a negative likelihood ratio of 0.03. This represents an increase in sensitivity, but a marginal reduction in specificity compared with a previous meta-analysis published in 2010, Dr. Henderson and colleagues note.

"There were deficiencies in all the studies evaluated," they say, "but especially with regard to important aspects, such as the use of a representative spectrum of patients, an acceptable reference standard (upper and lower endoscopy), and the poor reporting of current treatment modalities in use during fecal calprotectin sampling."

The researchers add that the marker's impact on endoscopy rates is still unclear, as is its role in re-evaluation of confirmed disease. Yet according to the new report, "The routine use of FC (fecal calprotectin) in the pediatric setting should significantly enhance our ability to more accurately screen children for IBD."

The researchers declared that they had no competing interests.


Am J Gastroenterol 2013.


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