RT Journal Article
SR Electronic
T1 Sampling endoscopically normal large bowel mucosa from patients presenting with elevated faecal calprotectin levels is not clinically justified
JF Journal of Clinical Pathology
JO J Clin Pathol
FD BMJ Publishing Group Ltd and Association of Clinical Pathologists
SP 205
OP 208
DO 10.1136/jclinpath-2020-207343
VO 75
IS 3
A1 Wong, Newton A C S
A1 Wallage, Michael John
A1 Virgo, Paul
A1 Lowes, Hannah
YR 2022
UL http://jcp.bmj.com/content/75/3/205.abstract
AB Aims and methods Faecal calprotectin (FCP) measurement is used especially to investigate for inflammatory bowel disease (IBD). To assess the utility of sampling endoscopically normal large bowel among patients first presenting with elevated FCP, this study identified 115 such patients out of 652 patients with elevated FCP from approximately 6000 primary care tests processed over 15 months.Results 23 cohort patients showed histologically abnormal large bowel biopsies. Only four cases demonstrated acute inflammation and two such patients only showed scattered cryptitis and did not develop IBD. A third patient demonstrated similar histology but, following repeat colonoscopy, her elevated FCP was attributed to small intestinal inflammation. Only the fourth patient’s large bowel biopsies showed features suggesting Crohn’s disease, but this represented an IBD detection rate out of 115 sets of large bowel biopsies of 0.9%.Conclusions Sampling of endoscopically normal large bowel among patients first presenting with elevated FCP is not clinically justified.