Fecal Calprotectin in Predicting Relapse of Inflammatory Bowel Disease in Children and Adolescents: A Meta-Analysis and Systematic Review.

The application of fecal calprotectin in the relapse of inflammatory bowel disease remains uncertain in children and adolescents. We systematically searched the common databases for eligible studies. Judgment of diagnostic accuracy included pooled sensitivity and specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and pooled area under the receiver operating characteristic curve. Ultimately, a total of 414 participants from six studies were included. The combined sensitivity, specificity, PLR, and NLR with 95% confidence intervals (CIs) were 0.85 (95% CI = 0.65 to 0.79), 0.71 (95% CI = 0.52 to 0.85), 2.95 (95% CI = 1.71 to 5.09), and 0.21 (95% CI = 0.08 to 0.51), respectively. The area under the summary receiver operating characteristic curve was 0.85, and the DOR was 14.14 (95% CI = 4.46 to 44.80). Our study showed that fecal calprotectin as a biomarker to predict the clinical relapse of inflammatory bowel disease during remission in children and adolescents is effective and worth applying. [Pediatr Ann. 2023;52(9):e357-e362.].

[1]  P. Hellström,et al.  Comparison of fecal calprotectin and serum C-reactive protein in early prediction of outcome to infliximab induction therapy , 2019, Scandinavian journal of gastroenterology.

[2]  W. Moon,et al.  Perspectives on Current and Novel Treatments for Inflammatory Bowel Disease , 2019, Gut and liver.

[3]  A. Griffiths,et al.  Clinical value of fecal calprotectin , 2019, Critical reviews in clinical laboratory sciences.

[4]  R. Brant,et al.  Consecutive fecal calprotectin measurements for predicting relapse in pediatric Crohn’s disease patients , 2019, World journal of gastroenterology.

[5]  I. Monteiro,et al.  Diagnosis and management of inflammatory bowel disease in children , 2017, British Medical Journal.

[6]  A. Enninger,et al.  Inflammatory Bowel Disease in Childhood and Adolescence. , 2017, Deutsches Arzteblatt international.

[7]  W. Khan,et al.  Comparison of Fecal Calprotectin Methods for Predicting Relapse of Pediatric Inflammatory Bowel Disease , 2017, Canadian journal of gastroenterology & hepatology.

[8]  V. Wolters,et al.  Raised faecal calprotectin is associated with subsequent symptomatic relapse, in children and adolescents with inflammatory bowel disease in clinical remission , 2017, Alimentary pharmacology & therapeutics.

[9]  Alexa R. Weingarden,et al.  Intestinal microbiota, fecal microbiota transplantation, and inflammatory bowel disease , 2017, Gut microbes.

[10]  R. Shamir,et al.  The natural history of pediatric-onset IBD-unclassified and prediction of Crohn’s disease reclassification: a 27-year study , 2017, Scandinavian journal of gastroenterology.

[11]  S. Saeed,et al.  Inflammatory Bowel Disease in Children and Adolescents. , 2021, Advances in pediatrics.

[12]  P. Lakatos,et al.  Age-related differences in presentation and course of inflammatory bowel disease: an update on the population-based literature. , 2014, Journal of Crohn's & colitis.

[13]  P. Henderson,et al.  The Diagnostic Accuracy of Fecal Calprotectin During the Investigation of Suspected Pediatric Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis , 2014, The American Journal of Gastroenterology.

[14]  M. Leeflang.  Systematic reviews and meta-analyses of diagnostic test accuracy. , 2014, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[15]  Paolo Eusebi,et al.  Diagnostic Accuracy Measures , 2013, Cerebrovascular Diseases.

[16]  P. V. van Rheenen.  Role of fecal calprotectin testing to predict relapse in teenagers with inflammatory bowel disease who report full disease control , 2012, Inflammatory bowel diseases.

[17]  P. Munkholm,et al.  Differences in phenotype and disease course in adult and paediatric inflammatory bowel disease – a population‐based study , 2011, Alimentary pharmacology & therapeutics.

[18]  P. Munkholm,et al.  Steroid dependency and pediatric inflammatory bowel disease in the era of immunomodulators—A population‐based study , 2011, Inflammatory bowel diseases.

[19]  P. V. van Rheenen,et al.  Faecal calprotectin for screening of patients with suspected inflammatory bowel disease: diagnostic meta-analysis , 2010, BMJ : British Medical Journal.

[20]  K. Kolho,et al.  Faecal calprotectin in children with clinically quiescent inflammatory bowel disease , 2010, Scandinavian journal of gastroenterology.

[21]  J. Girardet,et al.  Natural history of Crohn's disease: Comparison between childhood‐ and adult‐onset disease , 2010, Inflammatory bowel diseases.

[22]  David C Wilson,et al.  Definition of phenotypic characteristics of childhood-onset inflammatory bowel disease. , 2008, Gastroenterology.

[23]  M. Castro,et al.  Clinical role of calprotectin assay in determining histological relapses in children affected by inflammatory bowel diseases , 2008, Inflammatory bowel diseases.

[24]  Johannes B Reitsma,et al.  Evaluation of QUADAS, a tool for the quality assessment of diagnostic accuracy studies , 2006, BMC medical research methodology.

[25]  H. Tilg,et al.  3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn’s Disease 2016: Part 1 Diagnosis and Medical Management , 2017, Journal of Crohn's & colitis.

[26]  D. Turner,et al.  Differences in the management of pediatric and adult onset ulcerative colitis--lessons from the joint ECCO and ESPGHAN consensus guidelines for the management of pediatric ulcerative colitis. , 2014, Journal of Crohn's & colitis.

[27]  S. Orenstein.  Pediatric inflammatory bowel disease , 1999, Current gastroenterology reports.