Markers in IBD

Q; Which stool marker assesses intestinal inflammation in Inflammatory Bowel Disease (IBD)? - select one

A) CRP

B) ESR

C) calprotectin 

Answer: C

C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are serum markers that assess systemic inflammation.

The stool markers to assess intestinal inflammation are 

• fecal calprotectin 
• fecal lactoferrin 

Fecal calprotectin value of less than 50 mcg/g indicates that the mucosal disease likely remains in remission. Fecal lactoferrin is less commonly used.

#GI

References:

1. Patel A, Panchal H, Dubinsky MC. Fecal Calprotectin Levels Predict Histological Healing in Ulcerative Colitis. Inflamm Bowel Dis 2017; 23:1600.

2. Kawashima K, Ishihara S, Yuki T, et al. Fecal Calprotectin More Accurately Predicts Endoscopic Remission of Crohn's Disease than Serological Biomarkers Evaluated Using Balloon-assisted Enteroscopy. Inflamm Bowel Dis 2017; 23:2027.

3. D'Haens G, Ferrante M, Vermeire S, et al. Fecal calprotectin is a surrogate marker for endoscopic lesions in inflammatory bowel disease. Inflamm Bowel Dis 2012; 18:2218.

4. Menees SB, Powell C, Kurlander J, et al. A meta-analysis of the utility of C-reactive protein, erythrocyte sedimentation rate, fecal calprotectin, and fecal lactoferrin to exclude inflammatory bowel disease in adults with IBS. Am J Gastroenterol 2015; 110:444.

5. Monteiro S, Dias de Castro F, Leite S, et al. Low fecal calprotectin predicts clinical remission in Crohn's disease patients: the simple answer to a challenging question. Scand J Gastroenterol 2019; 54:49.