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* = Presenting author

P283 Effectiviness of fecal calprotectin measurement determining deep remission in Inflammatory Bowel Disease

O. Sezgin*1, B. Boztepe2, E. Altintas3, E.A. Kanik4, D. Ovla4

1Mersin , Gastroenterology, Mersin, Turkey, 2Keşan State Hospital, Internal Medicine, Edirne, Turkey, 3Mersin, Gastroenterology, Mersin, Turkey, 4Mersin, Biostatistics and Bioinformatics, Mersin, Turkey

Background

Deep remission is the desired end point of the treatment of inflamatory bowel disease (IBD). Deep remission criteria involve invasive procedures (colonoscopy and biopsy) which are unpleasant for patients. For this reason, non-invasive markers which are correlated with endoscopic and histopathological remission are being identified. Fecal calprotectin (FC) is one of these markers [1] . We aimed to study FC levels and its correlation with other inflamatory markers and colonoscopic-histopathological findings among our IBD patients who are at clinical remission.

Methods

43 patients with ulcerative colitis (UC), 38 patients with Crohn's disease (CD) who were at clinacal remission for at least 6 months and none of them was using steroids, and 41 healthy volunteers (who were admitted to screen for colon malignancy and whose colonoscopy were normal) were included in this study. CRP, sedimentation rate (SR), fibrinogen and FC levels were measured. Colonoscopy was performed to all IBD patients.

Results

Age and gender were similar between groups (UC: male 58%, female 42%, mean age 49; CD:male 50%,female 50%, mean age 46, Control:male 46%, female 53%,mean age 40). 70% of UC were distal and left-sided type, 25% of them was pancolitis. 85% of CD were ileocolic, 15% were colitis; 82% were inflamatory type. Mean FC and fibrinogen levels were high at UC and CD groups, and this difference between control and UC and CD group were statistically significant. CRP levels and SR were similar between the groups. CRP and FC levels were low at UC who were at endoscopic remission (statistically significant); SR and fibrinogen levels didn't show statistical difference. At histological remission, only FC was different between who were at histological remission and not. There were no difference between the levels of CRP, fibrinogen, and SR. In CD group, only FC level was low at endoscopic remission. There were no any difference between CRP, fibrinogen levels, and SR. There were no statistical difference between all inflammatory biomarkers to show histopathological remission at CD.

Conclusion

Although patients were at clinical remission, they could not be at endoscopic and histopathological remission. These Results show that clinical activity indexes are inadequate to show endoscopical and mucosal improvement [2] . FC levels are helpful to distinguish active disease from inactive disease. FC levels in patients with IBD are correlated with clinical, endoscopic and histopathological activity . FC was found more valuable than routinely used tests such as CRP and sedimentation rates to determine the disease activation.

References:

[1] D'Haens G, (2012), Fecal calprotectin is a surrogate marker for endoscopic lesions in inflammatory bowel disease

[2] Schirbel et al , (2010), Groupe d'Etudes Therapeutiques des affections inflmamtoires Digestive