A SURVEY OF FECAL CALPROTECTIN IN CHILDREN WITH NEWLY DIAGNOSED CELIAC DISEASE WITH VILLOUS ATROPHY

 Fecal calprotectin (FC) has been used as a diagnostic marker in intestinal inflammatory conditions.  As a few studies have been dedicated to assess the role of FC in coeliac disease (CD), the current study aimed to address this issue.  This study included 70 newly diagnosed CD (Marsh score 3) and 70 healthy children. The study was performed at the pediatric ward of Amir-Al-Momenin Hospital in Zabol city, the southeast of Iran, during June 2016-September 2017. The FC level was determined using a specific ELISA kit.  Women constituted 64.3% (45/70) and 55.1% (38/70) of CD and healthy children, respectively (P = 0.1). Three was no significant difference in the mean age between children with CD (6.3 ± 3.4) and without CD (8.3 ± 4.5) (P = 0.2). The mean level of FC was significantly higher in patients (239.1 ± 177.3 μg/g) than in healthy controls (38.5 ± 34.6 μg/g, P < 0.001). The titer of anti-tTG was significantly higher in patients than in healthy children (205.9 ± 156.2 U/mL vs. 6.7 ± 2.1 U/mL, respectively, P < 0.001). There was a significant correlation between the FC level and anti-tTG titer (r = 0.611, P < 0.001). However, the correlation was not statistically significant between FC and age (r = -0.154, 0.07). The ROC curve analysis revealed an AUC value of 0.893 (95% CI: 0.827 - 0.960, P < 0.001). At the level of 50 μg/g, FC rendered the sensitivity and specificity of 90% and 92%, respectively, for the diagnosis of CD. Positive predictive value (PPV) and negative predictive value (NPV) of FC at this cutoff value were 95.5% and 90.5%, respectively.  FC can be considered a screening complementary tool for detecting CD with high sensitivity and specificity.