Clinical usefulness of fecal calprotectin in assessing disease activity and endoscopic remission in intestinal Behçet's disease

Abstract

Background/Aims: Intestinal Beh & ccedil;et's disease (BD) is a manifestation of BD involving the gastrointestinal tract. Although fecal calprotectin (FC) is a useful inflammatory marker, its role in intestinal BD is unclear.<br /> Methods: We retrospectively analyzed 78 patients with intestinal BD to evaluate correlations between FC levels and the Disease Activity Index for Intestinal Beh & ccedil;et's Disease (DAIBD), C-reactive protein (CRP), and erythrocyte sedimentation rate. FC and CRP levels were compared between patients in endoscopic remission and those with active disease. Receiver operating characteristic (ROC) curve analysis was used to evaluate FC's ability to predict endoscopic activity and ulcer size.<br /> Results: FC levels significantly correlated with DAIBD scores (r= 0.253, P= 0.025) and CRP (r= 0.227, P= 0.046). Patients with endoscopically active disease had higher FC (1,124 +/- 1,957 mu g/g vs. 367 +/- 1,208 mu g/g; P< 0.001) and CRP levels (16.0 +/- 23.7 mg/L vs. 14.4 +/- 46.5 mg/L; P= 0.027) than those in remission. Patients with larger ulcers ( >= 30 mm) had higher FC levels than those with smaller ulcers (2,212 +/- 2,609 mu g/g vs. 962 +/- 1,822 mu g/g; P= 0.034). An FC cutoff level of 176 mu g/g discriminated active endoscopic disease (sensitivity 59.3%, specificity 83.3%), with an area under the ROC curve (AUC) of 0.724 (95% confidence interval, 0.605-0.843; P= 0.002), outperforming CRP (AUC, 0.657).<br /> Conclusions: FC levels correlated with DAIBD scores and endoscopic inflammation in intestinal BD. FC outperformed CRP in detecting endoscopic activity, supporting its use in disease management.