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Potential Utility of Fecal Calprotectin in Discriminating Colorectal Polyps From Other Major Etiologies in Children Presenting With Isolated Hematochezia

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Author(s)
Yu Bin KimJu Young KimSujin ChoiHyun Jin KimYoo Min LeeYoon LeeHyo-Jeong JangEun Hye LeeKyung Jae LeeSoon Chul KimSo Yoon ChoiYunkoo KangDae Yong YiYou Jin ChoiByung-Ho ChoeBen Kang
Keimyung Author(s)
Jang, Hyo Jeong
Department
Dept. of Pediatrics (소아청소년학)
Journal Title
J Korean Med Sci
Issued Date
2022
Volume
37
Issue
9
Keyword
Fecal CalprotectinColorectal PolypAnal FissureUlcerative ColitisHematochezia
Abstract
Background:
Colorectal polyps are the most common cause of isolated hematochezia in children, which requires a colonoscopy for diagnosis. We aimed to investigate the potential utility of fecal calprotectin (FC) in assessing colorectal polyps detected by colonoscopy among children presenting with isolated hematochezia.

Methods:
Pediatric patients of the age of < 18 years who had undergone both colonoscopy and FC tests for isolated hematochezia from June 2016 to May 2020 were included in the present multicenter, retrospective, cross-sectional study. Comparative analysis was conducted between major causes of isolated hematochezia and FC cut-offs for discriminating colorectal polyps were explored.

Results:
A total 127 patients were included. Thirty-five patients (27.6%) had colorectal polyps, followed by anal fissure (14.2%), ulcerative colitis (UC; 12.6%), and others. A significant difference in FC levels was observed between patients with colorectal polyps (median, 278.7 mg/kg), anal fissures (median, 42.2 mg/kg), and UC (median, 981 mg/kg) (P < 0.001). According to receiver operating characteristic curve analysis, among patients diagnosed with colorectal polyp or anal fissure, the most accurate FC cut-off for discriminating colorectal polyps from anal fissures on colonoscopy was 225 mg/kg (sensitivity, 59.4%; specificity, 94.4%; positive predictive value [PPV], 95.0%; negative predictive value [NPV], 56.7%; area under the curve [AUC], 0.8; 95% confidence interval [CI], 0.678–0.923; P < 0.001), while among patients diagnosed with colorectal polyp or UC, the most accurate FC cut-off for discriminating colorectal polyps from UC on colonoscopy was 879 mg/kg (sensitivity, 81.2%; specificity, 56.2%; PPV, 78.8%; NPV, 60.0%; AUC, 0.687; 95% CI, 0.521–0.852; P < 0.001).

Conclusion:
FC may assist in assessing the cause of lower gastrointestinal tract bleeding in children who present with isolated hematochezia.
Keimyung Author(s)(Kor)
장효정
Publisher
School of Medicine (의과대학)
Citation
Yu Bin Kim et al. (2022). Potential Utility of Fecal Calprotectin in Discriminating Colorectal Polyps From Other Major Etiologies in Children Presenting With Isolated Hematochezia. J Korean Med Sci, 37(9), e72. doi: 10.3346/jkms.2022.37.e72
Type
Article
ISSN
1598-6357
Source
https://jkms.org/search.php?where=aview&id=10.3346/jkms.2022.37.e72&code=0063JKMS&vmode=FULL
DOI
10.3346/jkms.2022.37.e72
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44084
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Pediatrics (소아청소년학)
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