Maria Hukkinen1, Mikko P Pakarinen2, Laura Merras-Salmio3, Antti Koivusalo4, Risto Rintala4, Kaija-Leena Kolho5. 1. Pediatric Liver and Gut Research Group, Children's Hospital, University of Helsinki, Finland. Electronic address: maria.hukkinen@helsinki.fi. 2. Pediatric Liver and Gut Research Group, Children's Hospital, University of Helsinki, Finland; Section of Pediatric Surgery, Children's Hospital, University of Helsinki, Finland. 3. Pediatric Liver and Gut Research Group, Children's Hospital, University of Helsinki, Finland; Section of Pediatric Gastroenterology, Children's Hospital, University of Helsinki, Finland. 4. Section of Pediatric Surgery, Children's Hospital, University of Helsinki, Finland. 5. Section of Pediatric Gastroenterology, Children's Hospital, University of Helsinki, Finland.
Abstract
BACKGROUND: Fecal calprotectin (FC) correlates with endoscopic recurrence of Crohn's disease (CD) in adults but has not been studied among children postoperatively. We aimed to analyze whether FC relates with postoperative CD recurrence in children. METHODS: Altogether 51 postoperative endoscopies and FC measurements from 22 patients having undergone surgery for CD at age ≤18years were included. RESULTS: Ileocecal resection (n=15), small bowel resection (n=6), or left hemicolectomy (n=1) was performed at median age of 15.1 (interquartile range 14.4-17.6) years. Following surgery, FC decreased significantly (659 vs. 103μg/g, p=0.001). During median follow-up of 5.7 (4.2-7.7) years, either endoscopic or histological recurrence occurred in 17 patients (77%). FC >139μg/g at time of endoscopy or FC increase of 79μg/g compared to first postoperative value was suggestive of endoscopic recurrence (Rutgeerts score i2-i4), while FC >101μg/g or increase of 21μg/g indicated histological recurrence. Best accuracy for prediction of recurrence was obtained by combining FC at endoscopy and the postoperative increase of FC. The corresponding AUROC values were 0.74 (95% 0.58-0.89) for endoscopic recurrence whereas 0.81 (95% CI 0.67-0.95) for histological recurrence. CONCLUSION: FC is a useful surrogate marker of postoperative recurrence also in pediatric CD patients.
BACKGROUND: Fecal calprotectin (FC) correlates with endoscopic recurrence of Crohn's disease (CD) in adults but has not been studied among children postoperatively. We aimed to analyze whether FC relates with postoperative CD recurrence in children. METHODS: Altogether 51 postoperative endoscopies and FC measurements from 22 patients having undergone surgery for CD at age ≤18years were included. RESULTS: Ileocecal resection (n=15), small bowel resection (n=6), or left hemicolectomy (n=1) was performed at median age of 15.1 (interquartile range 14.4-17.6) years. Following surgery, FC decreased significantly (659 vs. 103μg/g, p=0.001). During median follow-up of 5.7 (4.2-7.7) years, either endoscopic or histological recurrence occurred in 17 patients (77%). FC >139μg/g at time of endoscopy or FC increase of 79μg/g compared to first postoperative value was suggestive of endoscopic recurrence (Rutgeerts score i2-i4), while FC >101μg/g or increase of 21μg/g indicated histological recurrence. Best accuracy for prediction of recurrence was obtained by combining FC at endoscopy and the postoperative increase of FC. The corresponding AUROC values were 0.74 (95% 0.58-0.89) for endoscopic recurrence whereas 0.81 (95% CI 0.67-0.95) for histological recurrence. CONCLUSION:FC is a useful surrogate marker of postoperative recurrence also in pediatric CDpatients.
Authors: Eliza Lężyk-Ciemniak; Magdalena Tworkiewicz; Dominika Wilczyńska; Anna Szaflarska-Popławska; Aneta Krogulska Journal: Med Princ Pract Date: 2020-10-29 Impact factor: 1.927
Authors: Kristyna Zarubova; Ondrej Fabian; Ondrej Hradsky; Tereza Lerchova; Filip Mikus; Vojtech Dotlacil; Lucie Pos; Richard Skaba; Jiri Bronsky Journal: Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub Date: 2021-08-24 Impact factor: 1.648