BACKGROUND AND AIMS: Fecal calprotectin and lactoferrin are sensitive markers of mucosal inflammation. We compared three different assays in their ability to identify patients with organic intestinal disease. METHODS: In a post-hoc analysis of a prospective study, we examined 405 unselected patients with abdominal complaints referred for endoscopy to the University Hospital Basel, Switzerland. Calprotectin (EK-CAL, Bühlmann Laboratories, Switzerland; PhiCal, Calpro AS, Norway) and lactoferrin (IBD-Scan, Techlab, USA) were measured using enzyme-linked immunosorbent assays. The presence of a clinically significant endoscopic finding was the primary endpoint of the study. Final diagnoses were adjudicated blinded to calprotectin values. RESULTS: The prevalence of organic intestinal disease was 35.3%. Receiver operating characteristics analysis calculated an area under the curve (AUC) for EK-CAL of 0.918, which was significantly better than for PhiCal (AUC 0.842, P<0.001) and IBD-Scan (AUC 0.830, P=0.003) to identify patients with organic intestinal disease. Overall test accuracy was 88.1% for EK-CAL, 83.7% for PhiCal, and 81.3% for IBD-Scan. Optimal cut-off value calculated for PhiCal and IBD-Scan were lower than recommended by the manufacturer. CONCLUSIONS: Monoclonal testing of calprotectin is superior to both polyclonal calprotectin testing and fecal lactoferrin in identifying symptomatic patients with organic intestinal disease.
BACKGROUND AND AIMS: Fecal calprotectin and lactoferrin are sensitive markers of mucosal inflammation. We compared three different assays in their ability to identify patients with organic intestinal disease. METHODS: In a post-hoc analysis of a prospective study, we examined 405 unselected patients with abdominal complaints referred for endoscopy to the University Hospital Basel, Switzerland. Calprotectin (EK-CAL, Bühlmann Laboratories, Switzerland; PhiCal, Calpro AS, Norway) and lactoferrin (IBD-Scan, Techlab, USA) were measured using enzyme-linked immunosorbent assays. The presence of a clinically significant endoscopic finding was the primary endpoint of the study. Final diagnoses were adjudicated blinded to calprotectin values. RESULTS: The prevalence of organic intestinal disease was 35.3%. Receiver operating characteristics analysis calculated an area under the curve (AUC) for EK-CAL of 0.918, which was significantly better than for PhiCal (AUC 0.842, P<0.001) and IBD-Scan (AUC 0.830, P=0.003) to identify patients with organic intestinal disease. Overall test accuracy was 88.1% for EK-CAL, 83.7% for PhiCal, and 81.3% for IBD-Scan. Optimal cut-off value calculated for PhiCal and IBD-Scan were lower than recommended by the manufacturer. CONCLUSIONS: Monoclonal testing of calprotectin is superior to both polyclonal calprotectin testing and fecal lactoferrin in identifying symptomatic patients with organic intestinal disease.
Authors: Jeffrey S Hyams; Sonia Davis Thomas; Nathan Gotman; Yael Haberman; Rebekah Karns; Melanie Schirmer; Angela Mo; David R Mack; Brendan Boyle; Anne M Griffiths; Neal S LeLeiko; Cary G Sauer; David J Keljo; James Markowitz; Susan S Baker; Joel Rosh; Robert N Baldassano; Ashish Patel; Marian Pfefferkorn; Anthony Otley; Melvin Heyman; Joshua Noe; Maria Oliva-Hemker; Paul A Rufo; Jennifer Strople; David Ziring; Stephen L Guthery; Boris Sudel; Keith Benkov; Prateek Wali; Dedrick Moulton; Jonathan Evans; Michael D Kappelman; M Alison Marquis; Francisco A Sylvester; Margaret H Collins; Suresh Venkateswaran; Marla Dubinsky; Vin Tangpricha; Krista L Spada; Bradley Saul; Jessie Wang; Jose Serrano; Kevin Hommel; Urko M Marigorta; Greg Gibson; Ramnik J Xavier; Subra Kugathasan; Thomas Walters; Lee A Denson Journal: Lancet Date: 2019-03-29 Impact factor: 79.321
Authors: Elizabeth A Spencer; Sonia M Davis; David R Mack; Brendan M Boyle; Anne M Griffiths; Neal S LeLeiko; Cary G Sauer; David J Keljo; James F Markowitz; Susan S Baker; Joel R Rosh; Robert N Baldassano; Maria Oliva-Hemker; Marian D Pfefferkorn; Anthony R Otley; Melvin B Heyman; Joshua D Noe; Ashish S Patel; Paul A Rufo; M Alison Marquis; Thomas D Walters; Margaret H Collins; Subra Kugathasan; Lee A Denson; Jeffrey S Hyams; Marla C Dubinsky Journal: Inflamm Bowel Dis Date: 2018-05-18 Impact factor: 5.325
Authors: Jeffrey S Hyams; Michael Brimacombe; Yael Haberman; Thomas Walters; Greg Gibson; Angela Mo; David Mack; Anne Griffiths; Brendan Boyle; Neal LeLeiko; James Markowitz; Joel Rosh; Ashish Patel; Sapana Shah; Robert Baldassano; Marian Pfefferkorn; Cary Sauer; Joelynn Dailey; Suresh Venkateswaran; Subra Kugathasan; Lee A Denson Journal: Inflamm Bowel Dis Date: 2022-02-01 Impact factor: 5.325
Authors: Jeffrey S Hyams; Sonia Davis; David R Mack; Brendan Boyle; Anne M Griffiths; Neal S LeLeiko; Cary G Sauer; David J Keljo; James Markowitz; Susan S Baker; Joel Rosh; Robert N Baldassano; Ashish Patel; Marian Pfefferkorn; Anthony Otley; Melvin Heyman; Joshua Noe; Maria Oliva-Hemker; Paul Rufo; Jennifer Strople; David Ziring; Stephen L Guthery; Boris Sudel; Keith Benkov; Prateek Wali; Dedrick Moulton; Jonathan Evans; Michael D Kappelman; Alison Marquis; Francisco A Sylvester; Margaret H Collins; Suresh Venkateswaran; Marla Dubinsky; Vin Tangpricha; Krista L Spada; Ashley Britt; Bradley Saul; Nathan Gotman; Jessie Wang; Jose Serrano; Subra Kugathasan; Thomas Walters; Lee A Denson Journal: Lancet Gastroenterol Hepatol Date: 2017-09-20