Fecal calprotectin is a predictive marker of relapse in Crohn's disease involving the colon: a prospective study

Objectives Fecal calprotectin seems to have a diagnostic precision in predicting relapse in quiescent ulcerative colitis patients. However, the data remain controversial in Crohn's disease. The aim of this study was to prospectively evaluate the role of fecal calprotectin as a predictive marker for 1-year follow-up in patients with asymptomatic Crohn's disease. Methods Fifty-three Crohn's disease patients in clinical remission were consecutively included providing at the beginning of the study a single stool sample as well as a blood sample and regularly followed-up for 12 months. Fecal calprotectin level was measured using a commercially available enzyme-linked immunoassay. Results Among 53 patients, 10 (18.9%) developed clinical relapse during the 12-month follow-up period. Median fecal calprotectin level was significantly higher in relapse group patients compared with that in nonrelapse group (380.5 vs. 155 mu g/g, P < 0.001). With a cutoff value of 340 mu g/g fecal calprotectin gave sensitivity of 80% and specificity of 90.7% in predicting clinical relapse. Fecal calprotectin level greater that 340 mu g/g gave an 18-fold higher risk to develop relapse (log rank P < 0.001) and was found to be an independent predictive factor of relapse (P = 0.02). Conclusion Fecal calprotectin seems to be a reliable marker of relapse in quiescent Crohn's disease patients. Eur J Gastroenterol Hepatol 22: 340-345 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.