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P211 Pseudopolyps are associated with increased fecal calprotectin levels in patients with Inflammatory Bowel Disease in clinical and endoscopic remission.

Spigarelli De Rábago, I.(1);Suárez Ferrer, C.(2);Poza Cordón, J.(2);Martín Arranz, E.(2);Sánchez Azofra, M.(2);Rueda García, J.L.(2);Suarez Cabredo, C.G.(1);Hernández Pérez, M.(1);Martín Arranz, M.D.(2);

(1)La Paz University Hospital, Gastroenterology, Madrid, Spain;(2)Hospital la Paz Institute for Health Research - IdiPAZ La Paz University Hospital - Universidad Autónoma de Madrid, Gastroenterology, Madrid, Spain

Background

Fecal calprotectin (FC) has become a fundamental tool in the non-invasive monitorization of activity in patients with inflammatory bowel diseases (IBD). However, there is still debate over the choice of the optimal cut-off point for the different clinical settings. The aim of this study is to analyze whether the presence of pseudopolyps and their characteristics have an impact on the value of FC and should therefore be taken into account when deciding the optimal cutoff values. 

Methods

A single-centered, retrospective analysis including data from patients with colonic Crohn´s disease or Ulcerative colitis who underwent colonoscopy for dysplasia screening at our center between 2018 and 2019. Patients that did not have a FC registered within 8 months from to the colonoscopy, or that did not maintain clinical remission between the colonoscopy and the measurement of the FC, were excluded. Patients that had activity in the colonoscopy (Mayo endoscopic score >0, SESCD >0) were also excluded.

Results

73 patients were included. 26 (35.6%) of them had pseudopolyps in the colonoscopy. The median value of the FC was significantly different in patients with pseudopolyps (110.1 µg/g, CI 95% [48.6-171.5]) compared to those without them (52.5 µg/g, CI 95% [29.9-75.1]). In 11 (42.3%) of the patients with pseudopolyps, biopsies were taken, observing histological activity in 3 of them (27.3%) and no inflammatory activity in the other 8 (72.7%). We found that FC was higher in patients with inflammatory polyps (119.0 µg/g) in comparison to those without histological activity in their pseudopolyps (96.9 µg/g); however, these results were not statistically significant. The location of the pseudopolyps had no influence over the FC in our study. In addition, no correlation was found between the presence of polyps or diverticula and FC.

Conclusion

In our study, the presence of pseudopolyps is associated with significantly higher levels of FC. Moreover, our results suggest a tendency towards higher FC in patients who had active colitis in the histological samples of their pseudopolyps.

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