Diagnostic Value of Fecal Calprotectin in Children with Chronic Abdominal Pain

Abstract

Background: Chronic abdominal pain is one of the most common and most important complaints in children and adolescents, and it forms a diagnostic challenge for too many clinicians. The aim of the study is to establish whether fecal calprotectin concentration (FCC) may be useful in children with chronic abdominal pain to differentiate between functional gastrointestinal disorders and organic gastrointestinal disorders.

Methods: A prospective controlled study took a place in Children’s University Hospital in Damascus over a period of one year. It included 97 children (median age 7 years), 81 children with chronic abdominal pain and 16 healthy children as control. FCC was measured using ELISA assay to all children in study. According to final diagnosis, children were assigned to four study groups: control group, 16 healthy children; group of functional abdominal pain disorders, 19 children; group of organic gastrointestinal disorders (other than IBD), 41 children; group of children with IBD, 21 children.

Results: FCCs were low in control group and group of functional disorders (mean 20 mcg/g and 35 mcg/g respectively). All FCCs were below 50 mcg/g in control group, and most of them below 100 mcg/g in group of functional disorders. Meanwhile FCCs were elevated in group of organic disorders (mean 110 mcg/g), and they were markedly elevated in children with IBD (mean value 783 mcg/g). Significant differences in FCCs were found between the four groups of study. The cut off value of FCC to predict IBD was ≥89.5 mcg/g (sensitivity 90.5%; specificity 100%).

Conclusion: FCC is an excellent parameter allowing for differentiation between IBD, other inflammatory gastrointestinal disorders, and functional gastrointestinal disorders. High FCC is associated with a high probability of inflammatory gastrointestinal disorders, and it allows excluding functional gastrointestinal disorders.