Non-invasive Monitoring of Pouchitis After Total Proctocolectomy Using Fecal Calprotectin Levels.

Autor:	Kinugasa T; Department of Surgery, Department of Medicine, Kurume University School of Medicine., Mitsuyama K; Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine., Murotani K; Biostatistics Center, Kurume University Graduate School of Medicine., Mizobe T; Department of Surgery, Department of Medicine, Kurume University School of Medicine., Ochi T; Department of Surgery, Department of Medicine, Kurume University School of Medicine., Yoshimura T; Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine., Kuwaki K; Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine., Isobe T; Department of Surgery, Department of Medicine, Kurume University School of Medicine., Akagi Y; Department of Surgery, Department of Medicine, Kurume University School of Medicine.
Jazyk:	angličtina
Zdroj:	The Kurume medical journal [Kurume Med J] 2022 Nov 16; Vol. 67 (2.3), pp. 57-63. Date of Electronic Publication: 2022 Aug 10.
DOI:	10.2739/kurumemedj.MS6723005
Abstrakt:	Background: Fecal calprotectin (FC) is the most widely used marker for evaluating the disease activity of ulcerative colitis (UC). However, studies on FC in pouchitis after total proctocolectomy are scarce. We aimed to examine the correlations between the FC level and clinical findings and Pouchitis Disease Activity Index (PDAI) in UC patients who underwent total proctocolectomy (TP) with ileal pouch-anal canal anastomosis (IPAA) or ileal pouch-anal canal anastomosis (IACA). Methods: Between April 2008 and March 2018, 15 patients, consisting of 8 males and 7 females, with an average age at operation of 46.5 years, participated in this study. The average observation period was 68.3 months. The subjects underwent FC level measurements and endoscopic examinations. Results: The mean FC level was 418.69 μg/g (range: 10-1650 μg/g). Pouchitis was found in one (6.6%) patient, as detected by endoscopy. Among the 15 cases, FC levels were positively correlated with white blood cell count as well as albumin and C-reactive protein levels. There was a significant positive correlation between the PDAI score and FC levels (p<0.05). The median FC level was 111 mg/g in those with pouchitis, which was significantly higher than the 16 mg/g in those without pouchitis (p<0.05). Moreover, a significant positive correlation was found between the endoscopic findings of inflammation and FC levels (p<0.00005). Conclusion: FC levels were correlated with the PDAI score, blood testing data, and endoscopic findings, suggesting that the FC level could be a useful index of postoperative pouchitis and ileal pouch condition in patients undergoing TP with IPAA as UC treatment.
Databáze:	MEDLINE
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