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Journal of Medical Sciences
Year: 2014  |  Volume: 14  |  Issue: 4  |  Page No.: 179 - 191

Faecal Calgranulin C Versus Faecal Calprotectin as Non Invasive Markers Distinguishing Functional From Organic Causes of Chronic Diarrhea

Mohammed Amin Mohammed, Alaa Mahamad A. Hakeem El-Gamal, Nesreen Moustafa Omar, Abdelhadi M. Shebl, Amany H. Mansour, Sherin Mohamed Abd El-Aziz, Gamal Othman and Soad Amin Mohammed    

Abstract: The major challenge in inflammatory bowel disease is to achieve a sensitive and specific non invasive diagnostic marker. Recently, S100A12 (Calgranulin C) have been established to be elevated in the feces of patients with IBD. The objective was to investigate the utility of fecal S100A12, in comparison to fecal Calprotectin and standard inflammatory markers, as a screening and distinguishing marker for IBD and Irritable Bowel Syndrome (IBS) in patients with chronic diarrhea. Stool samples were obtained from 173 individuals presenting with gastrointestinal symptoms requiring endoscopy. Fecal S100A12, fecal Calprotectin and serum S100A12 levels were measured and correlated to final diagnosis and standard tests (ESR, CRP, platelet count, albumin, perinuclear anti-neutrophil and antineutrophil cytoplasmic antibodies. Full colonoscopy with histopathological examination was performed. Patients diagnosed with IBD had elevated fecal S100A12 (median 49.7 mg kg-1) and Calprotectin (median 385 mg kg-1) levels compared with the patients without IBD (n = 35, S100A12: Median 4.6 mg kg-1, p<0.0001, Calprotectin: Median 30.5 mg kg-1; p<0.0001). Both the sensitivity and specificity of fecal S100A12 (cutoff 8 mg kg-1) for the detection of IBD were 93.91 and 97%, respectively whereas fecal Calprotectin (cutoff 35 mg kg-1) gave a sensitivity of 93.96% and a specificity of 84.2%. Both fecal markers were superior to the sensitivities and specificities of any standard inflammatory test. Both fecal S100A12 and Calprotectin are sensitive markers of gastrointestinal inflammation but fecal S100A12 provided exceptional specificity in distinguishing patients with IBD from patients without IBD.

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