Fecal Calprotectin: A Screening Marker for the Early Detection of Necrotizing Enterocolitis among Children in Egypt

Background: Necrotizing enterocolitis (NEC) is a lethal disease affecting newborns with significant morbidity and mortality rates. Moreover, it is the most eminent gastrointestinal threat affecting premature newborns. Unfortunately, early symptoms and signs are usually vague; therefore, there is a s...

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Main Authors: Ayman Emil Eskander (Author), Rania Hosni Tomerak (Author), Mona Safwat (Author), Carolyne Ghobrial (Author), Mohammad Nabih Almohammady (Author), Walaa Abdelfattah (Author)
Format: Book
Published: Mashhad University of Medical Sciences, 2020-05-01T00:00:00Z.
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Summary:Background: Necrotizing enterocolitis (NEC) is a lethal disease affecting newborns with significant morbidity and mortality rates. Moreover, it is the most eminent gastrointestinal threat affecting premature newborns. Unfortunately, early symptoms and signs are usually vague; therefore, there is a special demand for sensitive biomarkers in this regard. This study aimed to investigate the role of fecal calprotectin in stage I NEC and identify specific cut off value at this stage to differentiate stage I NEC from other gastrointestinal disorders.<br />Methods: This cross-sectional study was conducted at New Children Hospital, Cairo University, Egypt. In total, 100 newborns were included in this study who were assigned to the patient group with stage I NEC (n=60) and control group (n=40)with age and gender-matched newborns.Fecal calprotectin level was assessed using an enzyme-linked immunosorbent assay in both groups. Follow up of the patient group was performed for the development of stage II or III NEC.<br />Results: The patient group obtained significantly elevated levels of fecal calprotectin, compared to the control group (P=0.000). Within the patient group, 43 (71.66%) newborns developed stage II or III NEC, whereas 17 (28.33%) cases developed no NEC. In addition, the level of fecal calprotectin was significantly higher in the group who developed stage II or III NEC (P=0.001). According to the receiver operating characteristic (ROC) curve, the cutoff value of 109.5 μg/g feces showed 100% sensitivity and specificity, and the area under the ROC curvewas equal to 1 in differentiating NEC from other conditions.<br />Conclusion: The study showed that fecal calprotectin can be used as a sensitive and specific marker for the early detection of necrotizing enterocolitis.
Item Description:2251-7510
2322-2158
10.22038/ijn.2020.41604.1684