Year 2016 / Volume 108 / Number 4
Original
Endoluminal calprotectin measurement in assessment of pouchitis and a new index of disease activity: a pilot study

190-195

DOI: 10.17235/reed.2016.4066/2015

Annamaria Pronio, Annalisa R. Di Filippo, Paola Mariani, Annarita Vestri, Chiara Montesani, Monica Boirivant,

Abstract
Pouchitis is the most common complication following proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis (UC). To provide a standardized definition of pouchitis clinical, endoscopic and histological markers were grouped and weighted in the pouch disease activity index (PDAI). However, the delay in the assessment of the final score due to the time requested for histological analysis remains the main obstacle to the index implementation in clinical practice so that the use of modified-PDAI (mPDAI) with exclusion of histologic subscore has been proposed. We tested the ability of calprotectin measurement in the pouch endoluminal content to mimic the histologic score as defined in the PDAI, the index that we adopted as gold standard for pouchitis diagnosis. Calprotectin was measured by ELISA in the pouch endoluminal content collected during endoscopy in 40 consecutive patients with J-pouch. In each patient PDAI and mPDAI were calculated and 15% of patients were erroneously classified by mPDAI. ROC analysis of calprotectin values vs. acute histological subscore ≥ 3 identified different calprotectin cut-off values with corresponding sensitivity and specificity allowing the definition and scoring of different range of calprotectin subscores. We incorporated the calprotectin score in the mPDAI obtaining a new score that shows the same specificity as PDAI for diagnosis of pouchitis and higher sensitivity when compared with mPDAI. The use of the proposed new score, once validated in a larger series of patients, might be useful in the early management of patients with symptoms of pouchitis.
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Pronio A, Di Filippo A, Mariani P, Vestri A, Montesani C, Boirivant M, et all. Endoluminal calprotectin measurement in assessment of pouchitis and a new index of disease activity: a pilot study. 4066/2015


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Publication history

Received: 22/10/2015

Accepted: 23/01/2016

Online First: 22/02/2016

Published: 01/04/2016

Article revision time: 91 days

Article Online First time: 123 days

Article editing time: 162 days


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