Fecal calprotectin is increasingly used during the diagnosis of inflammatory bowel disease (IBD), outperforming blood markers during investigation in children.
Tests that reduce endoscopy rates in children with suspected gut inflammation would be beneficial.
Dr Paul Henderson and colleagues from the United Kingdom determined the usefulness of fecal calprotectin in children undergoing their primary investigation for suspected IBD by systematic review and meta-analysis.
An electronic search was performed with keywords relating to IBD and calprotectin in multiple electronic resources from 1946 to 2012.
The research team also performed a hand search.
|Pooled sensitivity for the diagnostic utility of fecal calprotectin was 0.98 |
|American Journal of Gastroenterology|
Inclusion criteria were studies that reported fecal calprotectin levels before the endoscopic investigation of IBD in patients less than 18 years old.
Studies were evaluated using the Quality Assessment of Diagnostic Accuracy Studies tool, and a meta-analysis was performed using a hierarchical summary receiver operating curve model.
The team noted that 8 papers met the inclusion criteria.
Methodological quality was determined in detail for each study.
The team observed that 8 studies presented fecal calprotectin levels at presentation in 715 patients, 394 pediatric IBD patients, and 321 non-IBD controls.
Pooled sensitivity and specificity for the diagnostic utility of fecal calprotectin during the investigation of suspected pediatric IBD were 0.98 and 0.68, respectively.
The research team found that the positive and negative likelihood ratios were 3.07 and 0.03, respectively.
Dr Henderson's team concludes, "Fecal calprotectin has a high sensitivity and a modest specificity during the diagnosis of suspected pediatric IBD."
"Further work is required to determine the effect of fecal calprotectin levels on endoscopy rates and its role during the re-evaluation of those with confirmed disease."