calprotectine is not useful for screening of patients with small bowel crohn's disease
We have been very interested by the metaanalysis of van Rheenen et al (1).
However, we think that these results present limitations for crohn's
disease (CD). Calprotectine levels depend strongly with the phenotype of
this disease. Costa et al. found sensitivity and specificity around 90%
for predicting relapse in ulcerative colitis but their specificity of
calprotectine in CD was 43%. D'Inca et al. (3) reported that in CD
patients, only case of colonic CD showed a significant correlation between
a positive calprotectine test and a probability of release.
sensitivity and specificity of calprotectine in IBD patients were better
when only colonic CD were considered. So, bias may be present because
the authors pooled all patients without considering the phenotype of CD.
1- van Rheenen PF, Van de Vijver E, Fidler V.Faecal calprotectin for
screening of patients with suspected inflammatory bowel disease:
diagnostic meta-analysis. BMJ. 2010;341:c3369.
2- Costa F, Mumolo MG, Ceccarelli L, Bellini M, Romano MR, Sterpi C et al.
Calprotectin is a stronger predictive marker of relapse in ulcerative
colitis than in Crohn's disease.Gut. 2005;54:364-8.
3- D'Incà R, Dal Pont E, Di Leo V, Benazzato L, Martinato M, Lamboglia F
et al. Can calprotectin predict relapse risk in inflammatory bowel
disease? Am J Gastroenterol. 2008;103:2007-14.
Competing interests: No competing interests