Serkan İPEK, Cem ÇEKİÇ, Elif SARITAŞ YÜKSEL, M Eren KALENDER, Zeynep Zehra GÜMÜŞ, Mahmut ARABUL, Emrah ALPER, Belkıs ÜNSAL

İnflamatuvar barsak hastalığında fekal kalprotektinin akut faz reaktanları ve endoskopik aktivite indeksi ile korelasyonu ve hastalık şiddetine göre fekal kalprotektin düzeylerinin karşılaştırılması

Giriş ve Amaç: İnflamatuvar barsak hastalığında inflamasyonu gös- teren serum parametrelerindeki yükseklik, mukozal inflamasyona her zaman eşlik etmeyebilir. Bu durum araştırmacıları fekal markerlara yön- lendirmiştir. Bunlar içinde en sık kullanılan fekal kalprotektinin subklinik mukozal inflamasyonu tespit edebildiği ve relapsı olan hastaları daha erken tanımlayabildiği gösterilmiştir. Çalışmamızda, inflamatuvar barsak hastalığında fekal kalprotektinin lökosit sayısı, C-reaktif protein, eritro- sit sedimentasyon hızı ve endoskopik aktivite indeksiyle korelasyonunu değerlendirmeyi, ayrıca farklı hastalık şiddeti olan gruplar arasında fekal kalprotektin düzeylerini karşılaştırmayı amaçladık. Gereç ve Yöntem: Aktif inflamatuvar barsak hastalığı olanlarda fekal kalprotektin, C-re- aktif protein, eritrosit sedimentasyon hızı, lökosit sayısı ve endoskopik aktivite indeksi bakılarak, fekal kalprotektinin diğer parametrelerle ko- relasyonu değerlendirildi. Ayrıca hastalar hastalık aktivitesine göre ha- fif, orta ve şiddetli olarak ayrılarak gruplar arasında fekal kalprotektin düzeyleri karşılaştırıldı. Bulgular: Çalışmaya 40 ülseratif kolit, 25 Crohn hastası olmak üzere toplam 65 hasta dahil edildi. Fekal kalprotektinin ülseratif kolit hastalarında sadece eritrosit sedimentasyon hızı ile korele olduğu saptandı. Crohn hastalarında ise fekal kalprotektinin diğer tüm parametrelerle korele olduğu görüldü. Hastalık şiddetine göre gruplar arasında fekal kalprotektin düzeyleri açısından anlamlı fark saptanmadı. Sonuç: Çalışmamızda, inflamatuvar barsak hastalığında fekal kalprotek- tin düzeyleri açısından farklı hastalık şiddetine sahip gruplar arasında anlamlı fark saptanmadı. Bu konuda daha büyük çalışmalara ve yeni noninvaziv testlere ihtiyaç olduğunu düşünmekteyiz

Correlation of fecal calprotectin with acute phase reactants and endoscopic activity index and comparison of fecal calprotectin levels according to disease severity in inflammatory bowel disease

Background and Aims: Serum inflammatory markers do not always correlate with mucosal inflammation in inflammatory bowel diseases. This situation directed researchers to fecal inflammatory markers. Cal- protectin, the most common marker of fecal markers, can determine subclinical mucosal inflammation and the relapsed patients earlier. So, in this study, we aimed to evaluate the correlations of fecal calprotec- tin, white blood cell count, C-reactive protein, erythrocyte sedimenta- tion ratio and endoscopic activity index. We also aimed to compare the calprotectin levels of the groups with different disease activity. Ma- terials and Methods: We examined the patients with active disease and recorded their endoscopic activity indexes and the levels of fecal calprotectin, CRP, ESR and white blood cell count. We evaluated the correlations of these variables above. The patients classified in 3 groups due to mild, moderate and severe disease activity. Calprotectin levels of these groups were also compared. Results: Totally 65 patients (40 pa- tients with ulcerative colitis and 25 patients with Crohn’s disease) were included in this study. In ulcerative colitis patients, only fecal calpro- tectin was correlated with ESR. On the other hand, fecal calprotectin was correlated with all of other variables in Crohn’s disease patients. Fecal calprotectin levels showed no statistically significant difference between the groups with different disease activity. Conclusion: In this study, we could not demonstrate a relationship between fecal calpro- tectin levels and the groups due to disease activity. Further researches with larger sample size and new non-invasive tests are needed

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