Value of Fecal Calprotectin Measurement During the Initial Period of Therapeutic Anti-Tubercular Trial
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Background/Aims: The diagnosis of intestinal tuberculosis (ITB) is often challenging. Therapeutic anti-tubercular trial (TATT) issometimes used for the diagnosis of ITB. We aimed to evaluate the changing pattern of fecal calprotectin (FC) levels during TATT inpatients with ITB. Methods: A retrospective review was performed on the data of 39 patients who underwent TATT between September 2015 andNovember 2018 in five university hospitals in Daegu, South Korea. The analysis was performed for 33 patients with serial FCmeasurement reports. Results: The mean age of the participants was 48.8 years. The final diagnosis of ITB was confirmed in 30 patients based on completemucosal healing on follow-up colonoscopy performed after 2 months of TATT. Before starting TATT, the mean FC level of the ITBpatients was 170.2 μg/g (range, 11.5-646.5). It dropped to 25.4 μg/g (range, 11.5-75.3) and then 23.3 μg/g (range, 11.5-172.2) afterone and two months of TATT, respectively. The difference in mean FC before and one month after TATT was statistically significant(p<0.001), and FC levels decreased to below 100 μg/g in all patients after one month of TATT. Conclusions: All ITB patients showed FC decline after only 1 month of TATT, and this finding correlated with complete mucosalhealing in the follow-up colonoscopy after 2 months of TATT.
Abstract
Background/Aims: The diagnosis of intestinal tuberculosis (ITB) is often challenging. Therapeutic anti-tubercular trial (TATT) issometimes used for the diagnosis of ITB. We aimed to evaluate the changing pattern of fecal calprotectin (FC) levels during TATT inpatients with ITB. Methods: A retrospective review was performed on the data of 39 patients who underwent TATT between September 2015 andNovember 2018 in five university hospitals in Daegu, South Korea. The analysis was performed for 33 patients with serial FCmeasurement reports. Results: The mean age of the participants was 48.8 years. The final diagnosis of ITB was confirmed in 30 patients based on completemucosal healing on follow-up colonoscopy performed after 2 months of TATT. Before starting TATT, the mean FC level of the ITBpatients was 170.2 μg/g (range, 11.5-646.5). It dropped to 25.4 μg/g (range, 11.5-75.3) and then 23.3 μg/g (range, 11.5-172.2) afterone and two months of TATT, respectively. The difference in mean FC before and one month after TATT was statistically significant(p<0.001), and FC levels decreased to below 100 μg/g in all patients after one month of TATT. Conclusions: All ITB patients showed FC decline after only 1 month of TATT, and this finding correlated with complete mucosalhealing in the follow-up colonoscopy after 2 months of TATT.
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