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Combining faecal calprotectin and sigmoidoscopy can predict mucosal healing in paediatric ulcerative colitis

Authors
 Seung Kim  ;  Sowon Park  ;  Yunkoo Kang  ;  Hong Koh 
Citation
 EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, Vol.32(1) : 17-21, 2020 
Journal Title
 EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY 
ISSN
 0954-691X 
Issue Date
2020
Abstract
OBJECTIVES: Mucosal healing is the endoscopic treatment target in inflammatory bowel disease. The treat-to-target strategy, emphasizing proactive assessment and optimizing treatment, is commonly applied in the clinical setting. Although colonoscopies are essential for this strategy to be successful, bowel preparation and sedative drugs are required for paediatric patients. We attempted to verify the usefulness of sigmoidoscopy, which is less invasive than colonoscopy, combined with faecal calprotectin, to assess mucosal healing. METHODS: A total of 58 paediatric patients diagnosed with ulcerative colitis and followed up at Severance Children's Hospital from March 2015 to May 2018 were enrolled. Clinical data and laboratory findings (including faecal calprotectin and endoscopic data) were collected from medical records. The predictive power of mucosal healing of sigmoid colon and rectum (s-MH) combined with faecal calprotectin to predict mucosal healing throughout the colon was analysed. RESULTS: Among 58 patients (mean age 16.13 ± 2.88 years), 18 (31.0%) were in mucosal healing status. The median faecal calprotectin level was 486.5 μg/g. The faecal calprotectin cutoff value for predicting mucosal healing, identified using receiver-operating characteristic analyses, was 148 μg/g (area under the curve, 0.81). Sensitivity, specificity, positive predictive value, and negative predictive value of s-MH in predicting mucosal healing were 1.0, 0.82, 0.72, and 1.0, respectively. When we combined s-MH with faecal calprotectin less than the cutoff value, the sensitivity, specificity, positive predictive value, and negative predictive value were 0.56, 1.0, 1.0, and 0.83, respectively. CONCLUSION: For patients with a low faecal calprotectin level, sigmoidoscopy might be sufficient to assess mucosal healing.
Full Text
https://insights.ovid.com/crossref?an=00042737-202001000-00003
DOI
10.1097/MEG.0000000000001550
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Koh, Hong(고홍) ORCID logo https://orcid.org/0000-0002-3660-7483
Kim, Seung(김승) ORCID logo https://orcid.org/0000-0003-4373-9828
Park, So Won(박소원) ORCID logo https://orcid.org/0000-0002-2498-8004
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/174875
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