Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Fecal calprotectin concentration in neonatal necrotizing enterocolitis

  • Yoon, Jung Min (Department of Pediatrics, Konyang University College of Medicine) ;
  • Park, Ju Yi (Department of Pediatrics, Konyang University College of Medicine) ;
  • Ko, Kyung Ok (Department of Pediatrics, Konyang University College of Medicine) ;
  • Lim, Jae Woo (Department of Pediatrics, Konyang University College of Medicine) ;
  • Cheon, Eun Jeong (Department of Pediatrics, Konyang University College of Medicine) ;
  • Kim, Hyo Jeong (Department of Pediatrics, Konyang University College of Medicine)
  • Received : 2014.10.29
  • Accepted : 2014.03.24
  • Published : 2014.08.10
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Abstract

Purpose: Among the many factors associated with acute intestinal mucosal infection, numerous studies have proposed the usefulness of fecal calprotectin. The aim of this study was to evaluate the usefulness of fecal calprotectin in the diagnosis of necrotizing enterocolitis (NEC). Methods: We collected 154 stool samples from 16 very low birth weight and premature newborns at the Konyang University Hospital neonatal intensive care unit or neonatal nursery. The stool samples were collected using the Calprest device, and the fecal calprotectin level was measured with the $B\ddot{U}HLMANN$ Calprotectin enzyme-linked immunosorbent assay kit. Results: Fecal calprotectin levels were significantly higher in the NEC group than in the non-NEC group (P=0.02). There was a significant positive linear relationship between the fecal calprotectin level and number of days after birth (P=0.00) in the gestational age <26 weeks group. There was a significant negative linear relationship between the calprotectin level and number of days after birth (P=0.03) in the gestational age ${\geq}26$ weeks and <30 weeks group. There was no difference in the calprotectin levels according to the type and method of feeding between the NEC and non-NEC groups. Conclusion: Fecal calprotectin levels were significantly increased in premature infants with NEC. The fecal calprotectin test is a noninvasive, easy, and useful tool for the diagnosis of NEC.

Keywords

References

  1. Neu J, Walker WA. Necrotizing enterocolitis. N Engl J Med 2011;364:255-64.
  2. Thuijls G, Derikx JP, van Wijck K, Zimmermann LJ, Degraeuwe PL, Mulder TL, et al. Non-invasive markers for early diagnosis and determination of the severity of necrotizing enterocolitis. Ann Surg 2010;251:1174-80.
  3. Johne B, Fagerhol MK, Lyberg T, Prydz H, Brandtzaeg P, Naess-Andresen CF, et al. Functional and clinical aspects of the myelomonocyte protein calprotectin. Mol Pathol 1997;50:113-23.
  4. Roseth AG, Fagerhol MK, Aadland E, Schjonsby H. Assessment of the neutrophil dominating protein calprotectin in feces. A methodologic study. Scand J Gastroenterol 1992;27:793-8.
  5. Ton H, Brandsnes, Dale S, Holtlund J, Skuibina E, Schjonsby H, et al. Improved assay for fecal calprotectin. Clin Chim Acta 2000;292:41-54.
  6. Kristinsson J, Roseth A, Fagerhol MK, Aadland E, Schjonsby H, Bormer OP, et al. Fecal calprotectin concentration in patients with colorectal carcinoma. Dis Colon Rectum 1998;41:316-21.
  7. Berstad A, Arslan G, Folvik G. Relationship between intestinal permeability and calprotectin concentration in gut lavage fluid. Scand J Gastroenterol 2000;35:64-9.
  8. Roseth AG, Aadland E, Jahnsen J, Raknerud N. Assessment of disease activity in ulcerative colitis by faecal calprotectin, a novel granulocyte marker protein. Digestion 1997;58:176-80.
  9. Meling TR, Aabakken L, Roseth A, Osnes M. Faecal calprotectin shedding after short-term treatment with non-steroidal anti-inflammatory drugs. Scand J Gastroenterol 1996;31:339-44.
  10. Roseth AG, Schmidt PN, Fagerhol MK. Correlation between faecal excretion of indium-111-labelled granulocytes and calprotectin, a granulocyte marker protein, in patients with inflammatory bowel disease. Scand J Gastroenterol 1999;34:50-4.
  11. Aadland E, Fagerhol MK. Faecal calprotectin: a marker of inflammation throughout the intestinal tract. Eur J Gastroenterol Hepatol 2002;14:823-5.
  12. Golden BE, Clohessy PA, Russell G, Fagerhol MK. Calprotectin as a marker of inflammation in cystic fibrosis. Arch Dis Child 1996;74:136-9.
  13. Burri E, Beglinger C. Faecal calprotectin: a useful tool in the management of inflammatory bowel disease. Swiss Med Wkly 2012;142:w13557.
  14. Konikoff MR, Denson LA. Role of fecal calprotectin as a biomarker of intestinal inflammation in inflammatory bowel disease. Inflamm Bowel Dis 2006;12:524-34.
  15. Walsh MC, Kliegman RM. Necrotizing enterocolitis: treatment based on staging criteria. Pediatr Clin North Am 1986;33:179-201.
  16. Reisinger KW, Van der Zee DC, Brouwers HA, Kramer BW, van Heurn LW, Buurman WA, et al. Noninvasive measurement of fecal calprotectin and serum amyloid A combined with intestinal fatty acid-binding protein in necrotizing enterocolitis. J Pediatr Surg 2012;47:1640-5.
  17. Klip H, Burger CW, de Kraker J, van Leeuwen FE; OMEGA-project group. Risk of cancer in the offspring of women who underwent ovarian stimulation for IVF. Hum Reprod 2001;16:2451-8.
  18. Olafsdottir E, Aksnes L, Fluge G, Berstad A. Faecal calprotectin levels in infants with infantile colic, healthy infants, children with inflammatory bowel disease, children with recurrent abdominal pain and healthy children. Acta Paediatr 2002;91:45-50.
  19. Berni Canani R, Rapacciuolo L, Romano MT, Tanturri de Horatio L, Terrin G, Manguso F, et al. Diagnostic value of faecal calprotectin in paediatric gastroenterology clinical practice. Dig Liver Dis 2004;36:467-70.
  20. Carroll D, Corfield A, Spicer R, Cairns P. Faecal calprotectin concentrations and diagnosis of necrotising enterocolitis. Lancet 2003;361:310-1.
  21. Aydemir O, Aydemir C, Sarikabadayi YU, Emre Canpolat F, Erdeve O, Biyikli Z, et al. Fecal calprotectin levels are increased in infants with necrotizing enterocolitis. J Matern Fetal Neonatal Med 2012;25:2237-41.
  22. Shulman RJ, Ou CN, Smith EO. Evaluation of potential factors predicting attainment of full gavage feedings in preterm infants. Neonatology 2011;99:38-44.
  23. Josefsson S, Bunn SK, Domellof M. Fecal calprotectin in very low birth weight infants. J Pediatr Gastroenterol Nutr 2007;44:407-13.
  24. Rouge C, Butel MJ, Piloquet H, Ferraris L, Legrand A, Vodovar M, et al. Fecal calprotectin excretion in preterm infants during the neonatal period. PLoS One 2010;5:e11083.
  25. Hallstrom M, Koivisto AM, Janas M, Tammela O. Laboratory parameters predictive of developing necrotizing enterocolitis in infants born before 33 weeks of gestation. J Pediatr Surg 2006;41:792-8.
  26. Pourcyrous M, Korones SB, Yang W, Boulden TF, Bada HS. C-reactive protein in the diagnosis, management, and prognosis of neonatal necrotizing enterocolitis. Pediatrics 2005;116:1064-9.
  27. Isaacs D, North J, Lindsell D, Wilkinson AR. Serum acute phase reactants in necrotizing enterocolitis. Acta Paediatr Scand 1987;76:923-7.

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