Faecal calprotectin concentration in children with coeliac disease

Introduction
It is still unknown whether faecal calprotectin elevation may be caused by active untreated coeliac disease (CD) itself or whether it indicates the coexistence of CD and another disease associated with gastrointestinal inflammation.

Aim
To assess faecal calprotectin concentration (FCC) and its correlation with the clinical form and histopathological picture of the small intestine in children with CD.

Material and methods
Fifty-five children with newly recognised CD (mean age: 9.1 years) and 17 children with CD diagnosed at least year before and on a strict gluten-free diet (mean age: 12.3 years) were accepted for the study. Classical (n = 27), non-classical (n = 17), and asymptomatic form (n = 11) were distinguished in children with newly diagnosed CD based on the clinical picture. The histopathological small intestinal lesions were classified as Marsh 1 (n = 4), 3a (n = 5), 3b (n = 20), and 3c (n = 26). FCC was assessed using ELISA method with 50 µg/g as the upper limit of the normal.

Results
FCC was abnormal for 21 patients with newly diagnosed CD (38.2%) and for six patients from the treated group (35.3%). Mean FCC for the analysed group of patients was 91.7 ±144.8 µg/g, in the group with newly diagnosed CD – 100.9 ±154.4 µg/g, and in the treated group – 61.8 ±106.2 µg/g (Z = –1.333; p = 0.183). In the group of patients with recently diagnosed CD a statistically significant relationship was not observed for FCC and both clinical picture (2 = 0.319, p = 0.852) and severity of small intestinal lesions according to the Marsh classification (rho = 0.136).

Conclusions
Assessment of FCC seems to have no use as a marker for diagnostics and monitoring of CD irrespective of clinical form of the disease and severity of the inflammatory lesions within the small intestine.