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Does fecal calprotectin equally and accurately measure disease activity in small bowel and large bowel Crohn's disease? A systematic review

Simon, Ebby George; Wardle, Richard; Thi, Aye Aye; Eldridge, Jeanette; Samuel, Sunil; Moran, Gordon William


Ebby George Simon

Richard Wardle

Aye Aye Thi

Jeanette Eldridge

Sunil Samuel

Clinical Associate Professor


Fecal calprotectin (FC) is a highly sensitive disease activity biomarker in inflammatory bowel disease. However, there are conflicting reports on whether the diagnostic accuracy in Crohn’s disease is influenced by disease location. The aim of this study was to undertake a systematic review of the published literature. Relevant databases were searched from inception to November 8, 2016 for cohort and case control studies which had data on FC in patients with isolated small bowel (SB) and large bowel (LB) Crohn’s disease. Reference standards for disease activity were endoscopy, magnetic resonance imaging, computed tomography or a combination of these. The QUADAS-2 research tool was used to assess the risk of bias. There were 5,619 records identified at initial search. The 2,098 duplicates were removed and 3,521 records screened. Sixty-one full text articles were assessed for eligibility and 16 studies were included in the final review with sensitivities and specificities per disease location available from 8 studies. Sensitivities of FC at SB and LB locations ranged from 42.9% to 100% and 66.7% to 100% respectively while corresponding specificities were 50% to 100% and 28.6% to 100% respectively. The sensitivities and specificities of FC to accurately measure disease activity in Crohn’s disease at different disease locations are diverse and no firm conclusion can be made. Better studies need to be undertaken to categorically answer the effect of disease location on the diagnostic accuracy of FC.


Simon, E. G., Wardle, R., Thi, A. A., Eldridge, J., Samuel, S., & Moran, G. W. (2019). Does fecal calprotectin equally and accurately measure disease activity in small bowel and large bowel Crohn's disease? A systematic review. Intestinal Research, 17(2), 160-170.

Journal Article Type Article
Acceptance Date Jan 2, 2019
Online Publication Date Feb 7, 2019
Publication Date Apr 1, 2019
Deposit Date Jan 21, 2019
Publicly Available Date Jan 21, 2019
Journal Intestinal Research
Print ISSN 1598-9100
Electronic ISSN 2288-1956
Publisher Korean Association for the Study of Intestinal Diseases
Peer Reviewed Peer Reviewed
Volume 17
Issue 2
Pages 160-170
Public URL
Publisher URL


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