Highlights
- •Diagnostics of Crohn's disease (CD) is difficult and time-consuming.
- •Fecal lactoferrin (FL) is a new non-invasive marker in gastroenterology.
- •FL correlates with colonic mucosal lesions when compared with endoscopy.
- •FL concentration below 145.82 μg/ml has high sensitivity in detecting non-active CD.
- •FL can be helpful in optimizing the diagnostics and monitoring of CD.
Abstract
Background
Diagnosis and monitoring of Crohn's disease (CD) is difficult and time-consuming.
In recent years, diagnostic usefulness of fecal calprotectin has been proven. However,
data on the utility of other fecal markers are scarce.
Aims
To evaluate the usefulness of fecal lactoferrin (FL) in the assessment of CD activity.
Methods
The group consisted of 101 CD patients (median age: 30 years, IQR: 24–37). FL was measured in a single stool sample by using the immunoenzymatic
methods. The clinical activity of the disease was evaluated by using the Crohn's Disease
Activity Index (CDAI). Depending on the location of the disease, either a colonoscopy
or magnetic resonance enterography was performed or both in order to evaluate the
disease activity by using appropriate endoscopic and enterographic scores.
Results
Median FL concentration was 84.14 (IQR: 36.4–302.9) μg/ml and it correlated with C-reactive
protein concentration (p = 0.0000001, r = 0.5), CDAI (p = 0.002, r = 0.3) and colonic Simple Endoscopic Score for Crohn's Disease (SES-CD) (p = 0.000004, r = 0.5). Assuming endoscopic remission in the large intestine with colonic SES-CD ≤ 3 points, a ROC curve showed that FL concentration of 145.82 μg/ml had 84.6% sensitivity and 60.5% specificity in discriminating CD patients with
endoscopically active and inactive disease [AUC: 0.676 (95% CI: 0.531–0.8), (p = 0.0347)]. The positive predictive value for this concentration was 42% and negative
predictive value −92%.
Conclusions
FL is a sensitive marker of CD activity and it reliably reflects the mucosal inflammatory
lesions in large intestine. Thus, it can be helpful in diagnostics and monitoring
of CD.
Keywords
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Article info
Publication history
Published online: July 18, 2015
Accepted:
June 22,
2015
Received in revised form:
June 9,
2015
Received:
April 17,
2015
Identification
Copyright
© 2015 European Federation of Internal Medicine. Published by Elsevier Inc. All rights reserved.
