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ISSN (Print): 1574-8871
ISSN (Online): 1876-1038

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Research Article

Role of Fecal Calprotectin in Patients Presenting to the Emergency Department with Abdominal Pain with or without Diarrhea or Rectal Bleeding

Author(s): Angela Saviano, Carmine Petruzziello, Christian Zanza, Marcello Candelli, Maurizio Gabrielli, Alessio Migneco, Francesco Franceschi and Veronica Ojetti*

Volume 19, Issue 1, 2024

Published on: 26 October, 2023

Page: [70 - 75] Pages: 6

DOI: 10.2174/0115748871259008231006071656

Price: $65

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Abstract

Background and Objective: Abdominal pain is a frequent reason for admission to the Emergency Department. It may be a symptom of an underlying "organic" disease or a "functional" manifestation without an underlying anatomic or physiologic alteration. The evaluation of patients with abdominal pain is a challenge for the emergency physician and the selection of patients for second-level radiological examinations or endoscopic procedures is not always easy to perform. Faecal calprotectin could be a useful diagnostic marker to distinguish between "organic" or "functional" form and its determination could be helpful to select patients for further examinations in the context of an emergency setting.

Materials and Methods: This is an observational and retrospective study on 146 patients with abdominal pain and/or diarrhea (with or without rectal bleeding) admitted to the Emergency Department of Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, who collected a fecal sample to evaluate fecal calprotectin. We evaluated and correlated the level of fecal calprotectin with the final diagnosis they received. Results: 50/146 patients (34,24%) received a diagnosis of acute diverticulitis, in particular, 14/50 (28%) were complicated and 36/50 (72%) were uncomplicated; 4/146 (2,7%) were cholangitis, 32/146 (21,9%) were colitis, 6/146 (4,1%) gastritis, 42/146 (28,7%), Irritable bowel syndrome and 12/146 (8,2%) Inflammatory bowel disease. For the differential diagnosis between Irriable or inflammatory bowel diseses, our study showed a VPP and a VPN of 100% meanwhile for the differential diagnosis between Acute complicated and uncomplicated diverticulitis, our study showed a VPP of 40% and a VPN of 84%.

Conclusion: In the emergency setting, faecal calprotectin could be a helpful marker to select patients with abdominal pain who need second-level radiological examinations or endoscopic procedures, guiding the emergency physician in the evaluation of such a complex and wideranging symptom.

Keywords: Faecal, calprotectin, emergency department, abdominal pain, gut, symptom.

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[1]
Graff LG IV, Robinson D. Abdominal pain and emergency department evaluation. Emerg Med Clin North Am 2001; 19(1): 123-36.
[http://dx.doi.org/10.1016/S0733-8627(05)70171-1] [PMID: 11214394]
[2]
Cervellin G, Mora R, Ticinesi A, et al. Epidemiology and outcomes of acute abdominal pain in a large urban emergency department: Retrospective analysis of 5,340 cases. Ann Transl Med 2016; 4(19): 362.
[http://dx.doi.org/10.21037/atm.2016.09.10] [PMID: 27826565]
[3]
Macaluso C, McNamara RM. Evaluation and management of acute abdominal pain in the emergency department. Int J Gen Med 2012; 5: 789-97.
[http://dx.doi.org/10.2147/IJGM.S25936] [PMID: 23055768]
[4]
Grover M, Drossman DA. Functional abdominal pain. Curr Gastroenterol Rep 2010; 12(5): 391-8.
[http://dx.doi.org/10.1007/s11894-010-0125-0] [PMID: 20694840]
[5]
Pathirana WGW, Chubb SP, Gillett MJ, Vasikaran SD. Faecal calprotectin. Clin Biochem Rev 2018; 39(3): 77-90.
[PMID: 30828114]
[6]
Jafri L, Siddiqui A, Sidddique S, Parkash O, Kausar R, Majid H. Clinical spectrum in a cohort of patients with high fecal calprotectin levels. Cureus 2020; 12(11): e11314.
[http://dx.doi.org/10.7759/cureus.11314] [PMID: 33282590]
[7]
Barnes A, Spizzo P, Mountifield R. Inpatient usage of faecal calprotectin in a tertiary hospital. Intern Med J 2022; 52(3): 436-9.
[http://dx.doi.org/10.1111/imj.15086] [PMID: 33009839]
[8]
Kamin RA, Nowicki TA, Courtney DS, Powers RD. Pearls and pitfalls in the emergency department evaluation of abdominal pain. Emerg Med Clin North Am 2003; 21(1): 61-72.
[http://dx.doi.org/10.1016/S0733-8627(02)00080-9]
[9]
Lukens TW, Emerman C, Effron D. The natural history and clinical findings in undifferentiated abdominal pain. Ann Emerg Med 1993; 22(4): 690-6.
[http://dx.doi.org/10.1016/S0196-0644(05)81849-9] [PMID: 8457097]
[10]
Lewis LM, Banet GA, Blanda M, Hustey FM, Meldon SW, Gerson LW. Etiology and clinical course of abdominal pain in senior patients: A prospective, multicenter study. J Gerontol A Biol Sci Med Sci 2005; 60(8): 1071-6.
[http://dx.doi.org/10.1093/gerona/60.8.1071] [PMID: 16127115]
[11]
Orfanoudaki E, Drygiannakis I, Theodoraki E, Foteinogiannopoulou K, Mantaka A, Koutroubakis IE. Real-life utility and diagnostic accuracy of a home-performed fecal calprotectin test to predict endoscopic activity in patients with inflammatory bowel disease under maintenance treatment with adalimumab. Eur J Gastroenterol Hepatol 2021; 33(1S Suppl 1): e777-82..
[http://dx.doi.org/10.1097/MEG.0000000000002248]
[12]
Malvão LR, Madi K, Esberard BC, et al. Fecal calprotectin as a noninvasive test to predict deep remission in patients with ulcerative colitis. Medicine 2021; 100(3): e24058.
[http://dx.doi.org/10.1097/MD.0000000000024058] [PMID: 33546007]
[13]
Hovstadius H, Lundgren D, Karling P. Elevated faecal calprotectin in patients with a normal colonoscopy: Does it matter in clinical practice? a retrospective observational study. Inflamm Intest Dis 2021; 6(2): 101-8.
[http://dx.doi.org/10.1159/000513473] [PMID: 34124181]
[14]
Fodor I, Serban O, Serban DE, et al. The value of abdominal ultrasonography compared to colonoscopy and faecal calprotectin in following up paediatric patients with ulcerative colitis. Med Ultrason 2021; 23(2): 153-60.
[http://dx.doi.org/10.11152/mu-3005] [PMID: 33626119]
[15]
Duman M, Gencpinar P, Biçmen M, et al. Fecal calprotectin: Can be used to distinguish between bacterial and viral gastroenteritis in children? Am J Emerg Med 2015; 33(10): 1436-9.
[http://dx.doi.org/10.1016/j.ajem.2015.07.007] [PMID: 26233616]
[16]
Naismith GD, Smith LA, Barry SJE, et al. A prospective evaluation of the predictive value of faecal calprotectin in quiescent Crohn’s disease. J Crohn’s Colitis 2014; 8(9): 1022-9.
[http://dx.doi.org/10.1016/j.crohns.2014.01.029] [PMID: 24566170]
[17]
Naismith GD, Smith LA, Barry SJE, et al. A prospective single-centre evaluation of the intra-individual variability of faecal calprotectin in quiescent Crohn’s disease. Aliment Pharmacol Ther 2013; 37(6): 613-21.
[http://dx.doi.org/10.1111/apt.12221] [PMID: 23347334]
[18]
Moum B, Jahnsen J, Bernklev T. Fecal calprotectin variability in Crohnʼs disease. Inflamm Bowel Dis 2010; 16(7): 1091-2.
[http://dx.doi.org/10.1002/ibd.21136] [PMID: 19834972]
[19]
Haapamäki J, Tanskanen A, Roine RP, et al. Medication use among inflammatory bowel disease patients: excessive consumption of antidepressants and analgesics. Scand J Gastroenterol 2013; 48(1): 42-50.
[http://dx.doi.org/10.3109/00365521.2012.743584] [PMID: 23163864]
[20]
Jukic A, Bakiri L, Wagner EF, Tilg H, Adolph TE. Calprotectin: From biomarker to biological function. Gut 2021; 70(10): 1978-88.
[http://dx.doi.org/10.1136/gutjnl-2021-324855]
[21]
An YK, Prince D, Gardiner F, et al. Faecal calprotectin testing for identifying patients with organic gastrointestinal disease: Systematic review and meta-analysis. Med J Aust 2019; 211(10): 461-7.
[http://dx.doi.org/10.5694/mja2.50384]

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