ABSTRACT
Calprotectin is an abundant neutrophil protein which is extremely stable in feces. It is excreted in excess amount in feces during inflammatory bowel disease. This work aimed to study the relationship between faecal calprotectin concentrations and endscopic as well as histological gradings of disease activity in patients with ulcerative colitis [UC]. This study comprised 25 patients, who were confirmed to have UC by colonscopy and histological examination of colonic biopsies, in addition to 10 apparently healthy individuals as controls. Complete blood picture, C-reactive protein [CRP], erythrocytic sedimentation rate[ESR] and stool analysis were done for all studied individuals. In addition, faecal calprotectin was measured by using enzyme-linked immunosorbant assay [ELISA]. Colonoscopy was done for patients only and the severity of inflammation was assessed macroscopically and histologically by using the standard scoring systems. Patients were divided into patients with active UC and patients with no/low disease activity. Faecal calprotectin concentration was significantly higher in patients with UC [p<0.001] than in controls. Also, its levels were significantly higher in patients with active disease than in those with no/low activity [p<0.001]. Moreover faecal calprotectin concentrations increased significantly with the progression of both endoscopic and histological gradings of disease activity. Faecal calprotectin level was significantly higher in patients with active pancolitis than in those with left sided colitis or proctitis [p=0.003]. There was a significant positive correlation between both endoscopic as well as histological gradings of disease activity and faecal calprotectin. Also, faecal calprotectin significantly correlated with extent of the disease but there was no significant correlation with the clinical activity index, hemoglobin level, platelets count, leucocytic count, CRP and ESR. At cut-off value of 110mg/l faecal calprotectin detected active UC with a sensitivity of 93.3% and a specificity of 100% with a diagnostic accuracy of 96%. It was concluded that, faecal calprotectin level could be used as a non invasive marker of disease activity in patients with UC and it has the potential to reduce the number of invasive investigations performed in these patients