Faecal calprotectin or lactoferrin can identify postoperative recurrence in Crohn's disease

Authors

  • C. A. Lamb,

    1. Department of Gastroenterology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK
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  • M. K. Mohiuddin,

    1. Department of Colorectal Surgery, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK
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  • J. Gicquel,

    1. Department of Biochemistry, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK
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  • D. Neely,

    1. Department of Biochemistry, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK
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  • F. G. Bergin,

    1. Department of Colorectal Surgery, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK
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  • J. M. Hanson,

    1. Department of Colorectal Surgery, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK
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  • J. C. Mansfield

    Corresponding author
    1. Department of Gastroenterology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK
    • Department of Gastroenterology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK
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  • Presented to the Association of Surgeons of Great Britain and Ireland, Manchester, UK, April 2007 and published in abstract form as Br J Surg 2007; 94(Suppl 2): 2; and presented at United European Gastroenterology Week, Vienna, Austria, October 2008 and published as two abstracts, both Gut 2008; 57(Suppl 2): A139

  • The Editors are satisfied that all authors have contributed significantly to this publication

Abstract

Background:

Identifying Crohn's disease recurrence in symptomatic patients after ileocaecal resection is difficult. The aim of this study was to evaluate faecal concentrations of granulocyte degradation products in this setting.

Methods:

A postoperative cohort of 13 patients was followed prospectively for 1 year with regular faecal calprotectin (FC) and lactoferrin (FL) measurements. A second postoperative cohort (median 24 months after resection) of 104 patients provided a single stool sample. Faecal measurements were compared with symptom diaries, the Harvey Bradshaw Index, endoscopic examination, C-reactive protein and platelet measurement.

Results:

In the uncomplicated course, both markers normalized within 2 months. Both FC and FL correlated significantly with Harvey Bradshaw Index (P < 0·001). Twenty-eight patients with severely clinically active disease had high mean(s.e.) levels of FC (661·1(119·1) µg/g) and FL (116·6(32·2) µg/g); and 43 with clinically inactive disease had low levels of FC (70·2(27·1) µg/g) and FL (5·9(2·4) µg/g). In patients with mild to moderately clinically active disease, FC and FL identified individuals with and without recurrent inflammatory disease. Faecal markers were more accurate at predicting clinical disease activity than C-reactive protein, platelet count or endoscopic appearance.

Conclusion:

FC and FL are non-invasive tests that can help to identify disease recurrence in symptomatic postoperative patients. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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