Fecal calprotectin: its potential role in pediatric diseases and factors affecting levels

BACKGROUND: The aim of this study was to determine the diagnostic value of fecal calprotectin (FC) level in pediatric outpatients. FC is a non-invasive indicator of inflammation in the intestinal lumen. It can help in the diagnosis and follow-up of some inflammatory diseases.METHODS: The study was performed on 93 children aged 0-18 years retrospectively. Clinical and laboratory features were recorded in cases with FC results. The relationship between FC levels and the clinic-laboratory features of the patients was investigated.RESULTS: Of the 93 children, 48.4% (N.=45) were girls. The mean age was 102±63 months. The most common reasons for requesting FC by a physician were abdominal pain at 40.9% (N.=38) and diarrhea at 29% (N.=27), respectively. The mean FC was 234.16±383.99 µg/g, and the median was 66.00 µg/g. Spearman correlation analysis revealed a weak negative correlation between age and FC (rho=-0.228, P=0.028). Cesarean delivery and recent vaccination were associated with elevated FC. 58.1% of the cases (N.=54) had just been diagnosed. The mean FC and median were 307.7 and 79.5 µg/g in children with a new diagnosis, and they were 132.4 and 57 µg/g in undiagnosed children, respectively (P=0.066). Eight patients included in the study were diagnosed with inflammatory bowel disease (IBD), and most of them were older than 4 years.CONCLUSIONS: The present study did not show an association between referral complaints and fecal calprotectin. However, FC was higher in cases diagnosed with IBD. FC analysis seems more reasonable in patients with suspected IBD rather than in all cases with abdominal pain, diarrhea, or bloody stools.