Clin Endosc.  2022 Mar;55(2):256-262. 10.5946/ce.2021.061.

Value of Fecal Calprotectin Measurement During the Initial Period of Therapeutic Anti-Tubercular Trial

• Jo HH
• Kim EY
• Jung JT
• Kwon JG
• Kim ES
• Lee HS
• Lee YJ
• Kim KO
• Jang BI
• on behalf of the Crohn’s and Colitis Association in Daegu-Gyeongbuk (CCAiD)

• KMID: 2527570
• DOI: http://doi.org/10.5946/ce.2021.061

Abstract

Background/Aims
The diagnosis of intestinal tuberculosis (Itbc) is often challenging. Therapeutic anti-tubercular trial (TATT) is sometimes used for the diagnosis of Itbc. We aimed to evaluate the changing pattern of fecal calprotectin (FC) levels during TATT in patients with Itbc.
Methods
A retrospective review was performed on the data of 39 patients who underwent TATT between September 2015 and November 2018 in five university hospitals in Daegu, South Korea. The analysis was performed for 33 patients with serial FC measurement reports.
Results
The mean age of the participants was 48.8 years. The final diagnosis of Itbc was confirmed in 30 patients based on complete mucosal healing on follow-up colonoscopy performed after 2 months of TATT. Before starting TATT, the mean FC level of the Itbc patients was 170.2 μg/g (range, 11.5-646.5). It dropped to 25.4 μg/g (range, 11.5-75.3) and then 23.3 μg/g (range, 11.5-172.2) after one and two months of TATT, respectively. The difference in mean FC before and one month after TATT was statistically significant (p<0.001), and FC levels decreased to below 100 μg/g in all patients after one month of TATT.
Conclusions
All Itbc patients showed FC decline after only 1 month of TATT, and this finding correlated with complete mucosal healing in the follow-up colonoscopy after 2 months of TATT.

Keyword

Diagnosis; Fecal calprotectin; Intestinal tuberculosis; Therapeutic anti-tubercular trial

Figure

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  Fig. 1. Initial findings of inflammatory biomarkers in patients with intestinal tuberculosis. CRP, C-reactive protei; ESR, erythrocyte sedimentation rate.

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  Fig. 2. Changes in fecal calprotectin levels after therapeutic anti-tuberculosis trial in individual patients with intestinal tuberculosis.

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  Fig. 3. Changes in the mean value of fecal calprotectin levels after therapeutic anti-tubercular trial in intestinal tuberculosis patients. SE, standard error.

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