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Inflammatory bowel disease activity assessed by fecal calprotectin and lactoferrin: correlation with laboratory parameters, clinical, endoscopic and histological indexes

Andrea Vieira1*, Chia Bin Fang2, Ernani Geraldo Rolim1, Wilmar Artur Klug2, Flávio Steinwurz3, Lucio Giovanni Battista Rossini4 and Paulo Azevedo Candelária2

Author Affiliations

1 Clinic of Gastroenterology, Department of Medicine of the Irmandade de Misericórdia da Santa Casa de São Paulo, São Paulo, Brazil

2 Service of Coloproctology, Department of Surgery of the Irmandade de Misericórdia da Santa Casa de São Paulo, São Paulo, Brazil

3 Hospital Israelita Albert Einstein, São Paulo, Brazil

4 Service of Endoscopy of Irmandade Santa Casa de São Paulo, São Paulo, Brasil

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BMC Research Notes 2009, 2:221  doi:10.1186/1756-0500-2-221

Published: 29 October 2009

Abstract

Background

Research has shown that fecal biomarkers are useful to assess the activity of inflammatory bowel disease (IBD). The aim of the study is: to evaluate the efficacy of the fecal lactoferrin and calprotectin as indicators of inflammatory activity.

Findings

A total of 78 patients presenting inflammatory bowel disease were evaluated. Blood tests, the Crohn's Disease Activity Index (CDAI), Mayo Disease Activity Index (MDAI), and Crohn's Disease Endoscopic Index of Severity (CDEIS) were used for the clinical and endoscopic evaluation. Two tests were performed on the fecal samples, to check the levels of calprotectin and lactoferrin. The performance of these fecal markers for detection of inflammation with reference to endoscopic and histological inflammatory activity was assessed and calculated sensitivity, specificity, accuracy.

A total of 52 patient's samples whose histological evaluations showed inflammation, 49 were lactoferrin-positive, and 40 were calprotectin-positive (p = 0.000). Lactoferrin and calprotectin findings correlated with C-reactive protein in both the CD and UC groups (p = 0.006; p = 0.000), with CDAI values (p = 0.043; 0.010), CDEIS values in DC cases (p = 0,000; 0.000), and with MDAI values in UC cases (p = 0.000).

Conclusion

Fecal lactoferrin and calprotectin are highly sensitive and specific markers for detecting intestinal inflammation. Levels of fecal calprotectin have a proportional correlation to the degree of inflammation of the intestinal mucosa.