Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Value of Fecal Calprotectin Measurement During the Initial Period of Therapeutic Anti-Tubercular Trial

  • Hyeong Ho Jo (Department of Internal Medicine, Daegu Catholic University School of Medicine) ;
  • Eun Young Kim (Department of Internal Medicine, Daegu Catholic University School of Medicine) ;
  • Jin Tae Jung (Department of Internal Medicine, Daegu Catholic University School of Medicine) ;
  • Joong Goo Kwon (Department of Internal Medicine, Daegu Catholic University School of Medicine) ;
  • Eun Soo Kim (Department of Internal Medicine, School of Medicine, Kyungpook National University) ;
  • Hyun Seok Lee (Department of Internal Medicine, School of Medicine, Kyungpook National University) ;
  • Yoo Jin Lee (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Kyeong Ok Kim (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Byung Ik Jang (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Crohn's and Colitis Association in Daegu-Gyeongbuk (Crohn's and Colitis Association in Daegu-Gyeongbuk)
  • Received : 2021.01.25
  • Accepted : 2021.07.11
  • Published : 2022.03.30
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Abstract

Background/Aims: The diagnosis of intestinal tuberculosis (ITB) is often challenging. Therapeutic anti-tubercular trial (TATT) is sometimes used for the diagnosis of ITB. We aimed to evaluate the changing pattern of fecal calprotectin (FC) levels during TATT in patients with ITB. Methods: A retrospective review was performed on the data of 39 patients who underwent TATT between September 2015 and November 2018 in five university hospitals in Daegu, South Korea. The analysis was performed for 33 patients with serial FC measurement reports. Results: The mean age of the participants was 48.8 years. The final diagnosis of ITB was confirmed in 30 patients based on complete mucosal healing on follow-up colonoscopy performed after 2 months of TATT. Before starting TATT, the mean FC level of the ITB patients was 170.2 ㎍/g (range, 11.5-646.5). It dropped to 25.4 ㎍/g (range, 11.5-75.3) and then 23.3 ㎍/g (range, 11.5-172.2) after one 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 ㎍/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 mucosal healing in the follow-up colonoscopy after 2 months of TATT.

Keywords

Acknowledgement

We gratefully acknowledge the support of the members of the Crohn's and Colitis Association in Daegu-Gyeongbuk (CCAiD), especially Sung-kook Kim and Jun Heo.

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