İnflamatuvar Bağırsak Hastalığında Tanı Anındaki Fekal Kalprotektin Komplikasyon Varlığını Gösterebilir

Year 2024, , 1 - 8, 31.01.2024

Murat Erkut , Esra Özkaya , Sami Fidan , Arif Mansur Coşar

https://doi.org/10.16899/jcm.1362566

Abstract

Amaç: İnflamatuvar bağırsak hastalığı olan hastalarda tanı anında ya da takip esnasındaki komplikasyon varlığı ile fekal kalprotektin arasındaki ilişkiyi değerlendirmeyi amaçladık.
Gereç ve Yöntemler: Fekal kalprotektin düzeyi, kromatografik lateral akım immünoassay metodu ile çalışıldı
Bulgular: Çalışmaya 26’sı (%34) Crohn’s hastalığı ve 50’si (%66) ülseratif kolit olan toplam 76 hasta alındı. Tanı anı ve takip sırasında hastaların sırasıyla 17 (%22) ve 20’sinde (%26) komplikasyon gözlendi. Tanı anında fekal kalprotektin düzeyi 26 (%34) hastada düşük (<50 mg/kg), 16 (%21) hastada sınırda (50-100 mg/kg) ve 34 (%45) hastada yüksek (>100 mg/kg) idi. Fekal kalprotektin düzeyi yüksek olan hastalarda düşük olan hastalara göre hemoglobin ve albümin düzeyleri daha düşük (sırasıyla, p=0.013, p=0.012), trombosit, eritrosit sedimentasyon hızı ve C-reaktif protein düzeyleri daha yüksekti (sırasıyla, p<0.001, p=0.004, p<0.001). Hastaların tanı anı ve takipleri sırasında komplikasyon varlığı fekal kalprotektin düzeyi yüksek olanlarda, düşük ve sınırda olanlara göre daha yüksek oranda olduğu gözlendi (p=0.001). Fekal kalprotektin düzeyi >100 mg/kg olan hastalarda bu değerin altında olan hastalara göre tanı anında komplikasyon gelişme riskinin 26 kat, takip esnasında ise 8 kat daha yüksek olduğu tespit edildi (sırasıyla, p=0.006, p=0.015).
Sonuç: İnflamatuvar bağırsak hastalığında akut inflamasyonu gösteren tetkiklerle birlikte fekal kalprotektin düzeyinin kullanılması komplikasyon gelişimini öngörebilir.

Keywords

Fekal kalprotektin, inflamatuvar bağırsak hastalığı, komplikasyonlar, akut faz reaktanları

Fecal Calprotectin At The Time Of Diagnosis May Indicate The Presence Of Complications In Inflammatory Bowel Disease

Abstract

Aim: We aimed to investigate the relationship between the presence of complications at the time of diagnosis or during follow-up and fecal calprotectin in patients with inflammatory bowel disease.
Materials and Methods: Fecal calprotectin level was studied by the chromatographic lateral flow immunoassay method.
Results: A total of 76 patients, 26 (34%) with Crohn's disease and 50 (66%) with ulcerative colitis, were included in the study. At the time of diagnosis and during follow-up, complications were observed in 17 (22%) and 20 (26%) patients, respectively. At the time of diagnosis, fecal calprotectin level was low (<50 mg/kg) in 26 (34%) patients, borderline (50-100 mg/kg) in 16 (21%) patients, and high (>100 mg/kg) in 34 (45%) patients. Hemoglobin and albumin levels were lower (p=0.013, p=0.012, respectively), and platelet count, eryrocyte sedimentation rate, and C-reactive protein levels were higher (p<0.001, p=0.004, p<0.001, respectively) in patients with high fecal calprotectin level than patients with low fecal calprotectin level. At the time of diagnosis and during follow-up, complications were higher in patients with high fecal calprotectin level than patients with low and borderline fecal calprotectin levels (p=0.001). The risk of developing complications was found to be 26 times higher at the time of diagnosis in patients with fecal calprotectin level >100 µg/g than patients with fecal calprotectin level below this value and 8 times higher during follow-up (p=0.006, p=0.015, respectively).
Conclusion: The use of fecal calprotectin level together with tests showing acute inflammation in inflammatory bowel disease may predict the development of complications.

Keywords

Fecal calprotectin, inflammatory bowel disease, complications, acute phase reactants

Ethical Statement

This study protocol was reviewed and approved by local ethics committee of Karadeniz Technical University, Faculty of Medicine, approval number24237859-70

Supporting Institution

no

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