İnfantil Kolikli Bebeklerde Dışkıda Kalprotektin Düzeyleri

Year 2021, Volume: 21 Issue: 2, 105 - 110, 20.09.2021

Nalan Karabayır , Tülin Özden , O Durmaz , Gülbin Gökçay

Abstract

Amaç: Doğumu izleyen ilk üç ayda aşırı ağlama çok sık rastlanan bir yakın- madır. İnfantil kolik etyolojisi kesin olarak aydınlatılamamıştır. Son yıllarda intestinal mikrobiyatadaki değişikliklerin koliğe neden olabileceği ileri sürülmektedir. Çalışmamızın amacı dışkıda kalprotektin düzeylerinin ölçü- lerek kolik ile intestinal inflamasyon ilişkisinin araştırılmasıdır. Gereç ve Yöntem: Medipol Mega Üniversite hastanesi Genel Pediatri Polikliniğinde yapılan çalışmada 1-3 ay arası infantil kolikli 35 bebek (çalış- ma grubu) ile koliği olmayan 35 bebek olmak üzere toplam 70 bebeğin dışkıda kalprotektin düzeyleri İÜ Çocuk Gastroenteroloji Laboratuarında Elisa yöntemiyle ölçüldü. Kolik grubunda 22, kontrol grubunda 20 olmak üzere toplam 42 bebek bir yıl boyunca izlendi. Bulgular: Çalışma ve kontrol grubu bebekleri doğum tartısı, cins, doğum şekilleri, beslenme biçimleri açısından karşılaştırıldığında iki grup arasın- da fark saptanmadı. Çalışma grubunda kalprotektin düzeyleri anlamlı derecede yüksek olup, tüm olgularda fekal kalprotektin düzeyleri >250 μgr/g bulundu. Çalışma grubunun median kalprotektin değeri 651 μgr/g kontrol grubunun median değeri ise 354 μgr/g ölçüldü. Kalprotektin düzeyleri 350 μgr/g’den yüksek ve düşük olan olgular arasında doğum tartısı, cins, doğum şekli, beslenme biçimi ve probiyotik kullanımı açısın- dan anlamlı fark saptanmadı. Takipte kontrol grubunda 4, çalışma gru- bunda 3 olgu besin alerjisi tanısı aldı. Sonuç: Kolik bebeklerde yüksek dışkı kalprotektin seviyeleri, infantil kolik ve intestinal inflamasyonun ilişkili olabileceğini düşündürmektedir.

Keywords

Ağlama, infantil kolik, intestinal enflamasyon, kalpro- tektin, süt çocuğu

Thanks

Çalışmaya katkıda bulunan Dr Zeynep Arı, Dr Rüstem Bedel, Dr Bülent Erbarut ile katılan ailelere teşekkür ederim.

Fecal Calprotectin Levels in the Babies with Infantile Colic

Abstract

Objective: Excessive crying is one of the most common complaints in the first months of life. Although various theories have been proposed to explain infantile colic, the etiology is still unclear. The aim of this study is to measure fecal calprotectin levels in infants with and without infantile colic and to investigate their possible relationship with inflammation. Methods: Infants attending a General Pediatrics Clinic in Medipol Mega University Hospital constituted the study population. Fecal calprotectin levels were measured using the Elisa Method in a total of 70 infants aged 1-3 months, 35 of which had infantile colic. A total of 42 infants, 22 of whom were in the colic group and 20 of them in the control group were followed for one year. Results: The socio-demographic features and feeding types of the infants with or without infantile colic were similar. Fecal calprotectin levels were significantly higher in the colicky babies, and all had calprotectin levels > 250 μgr/g. The median fecal calprotectin values of the colic and control groups were 651 μgr/g and 354 μgr/g, respectively. No significant difference was found between the cases where the calprotectin levels were higher or lower than 350 μg/g in terms of birth weight, gender, mode of delivery, diet and use of probiotics. During the follow-up, symptoms of food allergy occurred in 4 patients in the control group and in 3 patients in the study group. Conclusion: High fecal calprotectin levels in the colic infants suggest that infantile colic and intestinal inflammation may be associated.

Keywords

Crying, calprotectin, infant, infantile colic, intestinal inflammation

References

• 1. Pankaj G. Infantil Colic-Unfolded. Indian J Pediatr 2004;71:903-6. google scholar
• 2. Rhoads JM, Fatheree NY, Norori JLiu, Lucke JF, Tyson JE, Ferris MJ. Altered fecal microflora and increased fecal calprotectin in infants with colic. J Pediatr 2004;155:823-8. google scholar
• 3. Johnson JD, Cocker K, Chang E. Infantile Colic: Recognition and Treatment. Am Fam Physician 2015;92:577-82. google scholar
• 4. Vandenplas Y, Alarcon P. Updated algorithms for managing frequent gastro-intestinal symptoms in infants. Beneficial Microbes 2015;6:199-208. google scholar
• 5. Partty A, Kalliomaki M, Salminen S, Isolauri E. Infantile colic is associated with low-grade systemic inflammation. J Pediatr Gastroenterol Nutr 2017;64:691-5. google scholar
• 6. Savino F, Garro M, Montanari P, Galliano I, Bergallo M. Crying Time and RORy/FOXP3 Expression in Lactobacillus reuteri DSM17938-Treated Infants with Colic: Randomized Trial. J Pediatr 2018;192:171-7. google scholar
• 7. Labbock M, Krasovec K. Toward consistency in breastfeeding definitions. Stud Fam Plann 1990;21:226230. google scholar
• 8. Wessel MA, Cobb JC, Jackson EB, Harris GS Jr, Detwiller AC. Paroxysmal fussing in infancy, sometimes called colic. Pediatrics 1954;14:421-35. google scholar
• 9. Ezri J, Nydegger A. Fecal calprotectin in children use and interpretation. Rev Med Suisse 2011;7:69-70. google scholar
• 10. Rhoads JM, Collins J, Fatheree NY, Hashmi S, Taylor CM, Luo M. et al. Infant Colic Represents Gut Inflammation and Dysbiosis. J Pediatr 2018;203:55-61. google scholar
• 11. Nocerino R, De Filippis F, Cecere G, Marino A, Micillo M, Di Scala C, et al. The therapeutic efficacy of Bifidobacterium animalis subsp. lactis BB-12® in infant colic: A randomised, double blind, placebo-controlled trial. Aliment Pharmacol Ther 2020;51:110-20. google scholar
• 12. Rhoads JM, Fatheree NY, Norori JLiu, Lucke JF, Tyson JE, Ferris MJ. Altered fecal microflora and increased fecal calprotectin in infants with colic. J Pediatr 2009;155:823-8. google scholar
• 13. Olafsdottir E, Aksnes L, Fluge G, Berstad A. Faecal calprotectin levels in infants with infantile colic, healthy infants, children with inflamatory bowel disease, children with recurrent abdominal pain and healthy children. Acta Paediatr 2002;91:45-50. google scholar
• 14. Savino F, Castagno E, Calabrese R, Viola S, Oggero R, Miniero R, et al. High faecal calprotectin levels in healthy,exclusively breast-fed infants. Neonatology 2010;97:299-304. google scholar
• 15. Saha A, Tighe MP, Batra A. How to use faecal calprotectin in management of paediatric inflammatory bowel disease. Arch Dis Child Educ Pract Ed 2016;101:124-8. google scholar
• 16. Carroccio A, Iacono G, Cottone M, Di Prima L, Cartabellotta F, Cavataio F, et al. Diagnostic accuracy of fecal calprotectin assay in distinguishing organic causes of chronic diarrhea from irritable bowel syndrome: a prospective study in adults and children. Clin Chem 2003;49(6 Pt 1);861-7. google scholar
• 17. Hestvik E, Tumwine JK, Tylleskar T, Grahnquist L, Ndeezi G, Kaddu-Mulindwa DH, et al. Faecal calprotectin concentrations in apparently healthy children aged 0-12 years in urban Kampala, Uganda: a community-based survey. BMC Pediatr 2011;11:9. google scholar
• 18. Kapel N, Campeotto F, Kalach N, Baldassare M, Butel MJ, Dupont C. Faecal calprotectin in term and preterm neonates. J Pediatr Gastroenterol Nutr 2010;51:542-7. google scholar
• 19. Oord T, Hornung N. Fecal calprotectin in healthy children. Scand J Clin Lab Invest 2014;74:254-8. google scholar
• 20. Rugtveit J,Fagerhol MK. Age-dependent variations in fecal calprotectin concentrations in children. J Pediatr Gastroenterol Nutr 2002;34:323-4. google scholar
• 21. Sahin Gunaydin BS, Keskindemirci G, Ozden TA, Durmaz O, Gokcay G. Faecal calprotectin levels during the first year of life in healthy children. J Paed Child Health 2020. google scholar
• 22. Dorosko SM, MacKenze T, Connor RI. Fecal calprotectin concentrations are higher in exclusively breatfed infants compared to those who are mixed -fed. Breasfeeding Med 2008;3:117-9. google scholar
• 23. Campeotto F, Butel MJ, Kalach N, Derrieux S, Aubert-Jacquin C, Barbot L, et al. High faecal calprotectin concentrations in newborn infants. Arch Dis Child Fetal Neonatal ed 2004;89:353-5. google scholar
• 24. Castro F, de Souza HSP. Dietary Composition and Effects in Inflammatory Bowel Disease. Nutrients 2019;11:1398. google scholar