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Diagnostic Accuracy of Fecal Calprotectin Assay in Distinguishing Organic Causes of Chronic Diarrhea from Irritable Bowel Syndrome: A Prospective Study in Adults and Children (Evidence-Based Laboratory Medicine and Test Utilization) (Clinical Report)

eBook details

Title: Diagnostic Accuracy of Fecal Calprotectin Assay in Distinguishing Organic Causes of Chronic Diarrhea from Irritable Bowel Syndrome: A Prospective Study in Adults and Children (Evidence-Based Laboratory Medicine and Test Utilization) (Clinical Report)
Author : Clinical Chemistry
Release Date : January 01, 2003
Genre: Chemistry,Books,Science & Nature,
Pages : * pages
Size : 249 KB

Description

Irritable bowel syndrome (IBS) [5] is one the most frequent causes of chronic diarrhea in adult patients, and previous studies have suggested that a careful standard medical history could suggest IBS diagnosis rather than an organic disease (1, 2). However, the diagnostic work-up of patients with diarrhea and suspected IBS includes a barium x-ray study of the colon or sigmoidoscopy, and colonoscopy is recommended for patients over the age of 50 (3). Consequently, to avoid invasive investigations, several noninvasive markers have been suggested to distinguish functional gastrointestinal disorders from "organic" diseases. Among these, fecal calprotectin (FC) concentrations have been shown to be a good marker of organic disease, being higher in patients with inflammatory bowel disease (IBD) (4) and colorectal carcinoma than in controls (5). Calprotectin constitutes ~60% of the soluble cytosol proteins in neutrophil granulocytes and plays a central role in neutrophil defense. Consequently, its concentration in stool correlates with the intensity of neutrophil infiltration of the intestinal mucosa and with the severity of inflammation. Furthermore, its in vivo and in vitro resistance to degradation allows fecal samples to be assayed for a reliable calprotectin determination (6). Most previous studies on the FC assay, however, were carried out on prediagnosed groups of patients, and its diagnostic accuracy in distinguishing organic from "functional" diarrhea has rarely been evaluated in adult patients (4, 7, 8) and never in children. The aim of the present study was to evaluate the positive and negative predictive values of the FC assay in identifying the organic causes of chronic diarrhea in consecutive individuals referred as outpatients to gastro-enterology centers both for adults and for children.