Año 2016 / Volumen 108 / Número 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,

Resumen
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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Bibliografía
1. Ståhlberg D, Gullberg K, Liljeqvist L, et al. Pouchitis following pelvic pouch operation forulcerative colitis: incidence, cumulative risk, and risk factors. Dis Colon Rectum 1996; 39:1012-8.
2. Simchuk EJ, Thirlby RC. Risk factors and true incidence of pouchitis in patients after ileal pouch-anal anastomoses. World J Surg 2000; 24: 851-6
3. Ferrante M, Declerck S, De Hertogh G, et al. Outcome after proctocolectomy with ileal pouch–anal anastomosis for ulcerative colitis. Inflamm. Bowel Dis. 2008; 14: 20–8
4. Sandborn WJ. Pouchitis following ileal pouch-anal anastomosis: definition, pathogenesis, and treatment. Gastroenterology 1994; 107: 1856-60
5. Mahadevan U, Sandborn WJ. Diagnosis and management of pouchitis. Gastroenterology 2003;124: 1636–50
6. Sandborn WJ, Tremaine WJ, Batts KP, et al. Pouchitis after ileal pouch-anal anastomosis: a Pouchitis Disease Activity Index. Mayo Clin Proc 1994; 69: 409-15
7. Shen B. Pouchitis: what every gastroenterologist needs to know. Clin Gastroenterol Hepatol. 2013;11:1538-49
8. Shen B, Achkar JP, Connor JT, et al. Modified pouchitis disease activity index: a simplifiedapproach to the diagnosis of pouchitis. Dis Colon Rectum 2003;46:748–53
9. Kopylov U, Rosenfeld G, Bressler B, et al. Clinical utility of fecal biomarkers for the diagnosis and management of inflammatory bowel disease. Infl amm Bowel Dis 2014; 20: 742– 56
10. D'Haens G, Ferrante M, Vermeire S, et al. Fecal calprotectin is a surrogate marker for endoscopic lesions in inflammatory bowel disease. Inflamm Bowel Dis 2012; 18: 2218 –24.
11. Farkas K, Saródi Z, Bálint A, et al. The diagnostic value of a new fecal marker, matrix metalloprotease-9, in different types of inflammatory bowel diseases. J Crohns Colitis. 2015; 9:231-7
12. Bonnín Tomàs A, Vila Vidal M, Rosell Camps A. Fecal calprotectin as a biomarker to distinguish between organic and functional gastrointestinal disease. Rev Esp Enferm Dig. 2007; 99:689-93
13. Johnson MW, Maestranzi S, Duffy AM, et al. Faecal calprotectin: a noninvasive diagnostic tool and marker of severity in pouchitis. Eur J Gastroenterol Hepatol. 2008; 20:174–9
14. Yamamoto T, Shimoyama T, Bamba T, et al. Consecutive Monitoring of Fecal Calprotectin and Lactoferrin for the Early Diagnosis and Prediction of Pouchitis after Restorative Proctocolectomy for Ulcerative Colitis. Am J Gastroenterol. 2015;110:881-7
15. Shen, B. Acute and chronic pouchitis—pathogenesis, diagnosis and treatment Nat. Rev.Gastroenterol. Hepatol. 2012; 9: 323–33
16. Shepherd NA, Jass JR, Duval I, et al. Restorative proctocolectomy with ileal reservoir: pathological and histochemical study of mucosal biopsy specimens. J Clin Pathol 1987; 40:601-7
17. Røseth AG, Aadland E, Jahnsen J, et al. Assessment of disease activity in ulcerative colitis by faecal calprotectin , a novel granulocyte marker protein. Digestion 1997; 58:176-80
18. Heuschen UA, Allemeyer EH, Hinz U, et al. Diagnosing pouchitis: comparative validation of two scoring systems in routine follow-up. Dis Colon Rectum 2002; 45:776–6
19. Shen B, Achkar JP, Lashner BA, et al. Endoscopic and histologic evaluations together with symptom assessment are required for the diagnosis of pouchitis. Gastroenterology 2001; 121:261–7
20. Kariv R, Plesec TP, Gaffney K, et al. Pyloric gland metaplasia and pouchitis in patients with ileal pouch-anal anastomoses. Aliment Pharmacol Ther. 2010; 31:862-73
21. Labaere D, Smismans A, Van Olmen A, et al. Comparison of six different calprotectin assays for the assessment of inflammatory bowel diseases. United European Gastroenterol J 2014; 2:30-7
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Instrucciones para citar
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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Ficha Técnica

Recibido: 22/10/2015

Aceptado: 23/01/2016

Prepublicado: 22/02/2016

Publicado: 01/04/2016

Tiempo de revisión del artículo: 91 días

Tiempo de prepublicación: 123 días

Tiempo de edición del artículo: 162 días


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