Potential Utility of Fecal Calprotectin in Discriminating Colorectal Polyps From Other Major Etiologies in Children Presenting With Isolated Hematochezia
- Author:
Yu Bin KIM
1
;
Ju Young KIM
;
Sujin CHOI
;
Hyun Jin KIM
;
Yoo Min LEE
;
Yoon LEE
;
Hyo-Jeong JANG
;
Eun Hye LEE
;
Kyung Jae LEE
;
Soon Chul KIM
;
So Yoon CHOI
;
Yunkoo KANG
;
Dae Yong YI
;
You Jin CHOI
;
Byung-Ho CHOE
;
Ben KANG
Author Information
- Publication Type:Original Article
- From:Journal of Korean Medical Science 2022;37(9):e72-
- CountryRepublic of Korea
- Language:English
-
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%; negativepredictive 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.
