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P106. Faecal calprotectin: Useful for clinical differentiation of microscopic colitis and irritable bowel syndrome?

U. von Arnim, C. Ganzert, T. Wex, P. Malfertheiner

Otto-von-Guericke University, Magdeburg, Germany

Objectives: To compare two methods for measuring faecal calprotectin concentration and to evaluate the possibility of differentiation between microscopic colitis (MC) and irritable bowel syndrome (IBS).

Methods: Twenty-four patients with MC (6 patients with active disease; 18 patients retested in remission) and 10 patients with IBS were prospectively included. Active disease of microscopic colitis was determined by clinical pathology of bowel frequency per day >3 and histological correlate. All patients received ileocolonoscopy including segmental biopsy samples, histology. Calprotectin levels in feacal samples were analysed using a rapid test system (Quantum Blue) and an enzyme-linked immunosorbent assay (ELISA).

Results: Faecal calprotectin levels were significantly higher in patients with active microscopic colitis [median 48 μg/g (95% confidence interval: 23–106)] compared to patients with IBS [2 μg/g (1–5), p = 0.0002] using ELISA. Faecal calprotectin levels of patients with MC in remission were (21 μg/g (1–216)). The difference of faecal calprotectin levels between active MC and IBS could not be detected by the rapid test (Quantum Blue, p = 0.635).

Discussion: Thus faecal calprotectin levels might serve as parameter for differentiation between patients with active MC and IBS. Since there is no surrogate marker available for MC, faecal calprotectin should be taken into account especially when differentiating from IBS. If this might help to reduce unnecessary endoscopies should be evaluated in further clinical studies.

Conclusion: Elevated feacal calprotectin levels, which were analyzed by ELISA, are a potential marker for patients with active MC compared to those with IBS. The rapid test was not found to be suitable for these patients.