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Predicting inflammatory bowel disease in children with abdominal pain and diarrhoea : calgranulin-C versus calprotectin stool tests

(2018) ARCHIVES OF DISEASE IN CHILDHOOD. 103(6). p.565-571
Author
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Abstract
Objective: Calgranulin-C (S100A12) is a new faecal marker of inflammation that is potentially more specific for inflammatory bowel disease (IBD) than calprotectin, since it is only released by activated granulocytes. We compared calgranulin-C and calprotectin to see which of the two tests best predicted IBD in children with chronic abdominal pain and diarrhoea. Design: Delayed-type cross-sectional diagnostic study. Setting and patients Previously undiagnosed patients aged 6-17years, who were seen in paediatric clinics in the Netherlands and Belgium, sent in a stool sample for analysis. Patients with a high likelihood of IBD underwent upper and lower endoscopy (ie, preferred reference test), while those with a low likelihood were followed for 6 months for latent IBD to become visible (ie, alternative reference test). We used Bayesian modelling to correct for differential verification bias. Main outcome measures: Primary outcome was the specificity for IBD using predefined test thresholds (calgranulin-C: 0.75 mu g/g, calprotectin: 50 mu g/g). Secondary outcome was the test accuracy with thresholds based on receiver operating characteristics (ROC) analysis. Results: IBD was diagnosed in 93 of 337 patients. Calgranulin-C had significantly better specificity than calprotectin when predefined thresholds were used (97% (95% credible interval (Cl) 94% to 99%) vs 71% (95% Cl 63% to 79%), respectively). When ROC-based thresholds were used (calgranulin-C: 0.75 mu g/g, calprotectin: 400 mu g/g), both tests performed equally well (specificity: 97% (95% Cl 94% to 99%) vs 98% (95% Cl 95% to 100%)). Conclusions: Both calgranulin-C and calprotectin have excellent test characteristics to predict IBD and justify endoscopy.
Keywords
FECAL CALPROTECTIN, DIAGNOSTIC-ACCURACY, NONINVASIVE MARKER, S100A12

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MLA
Heida, Anke et al. “Predicting Inflammatory Bowel Disease in Children with Abdominal Pain and Diarrhoea : calgranulin-C Versus Calprotectin Stool Tests.” ARCHIVES OF DISEASE IN CHILDHOOD 103.6 (2018): 565–571. Print.
APA
Heida, A., Van de Vijver, E., van Ravenzwaaij, D., Van Biervliet, S., Hummel, T. Z., Yuksel, Z., Gonera-de Jong, G., et al. (2018). Predicting inflammatory bowel disease in children with abdominal pain and diarrhoea : calgranulin-C versus calprotectin stool tests. ARCHIVES OF DISEASE IN CHILDHOOD, 103(6), 565–571.
Chicago author-date
Heida, Anke, Els Van de Vijver, Don van Ravenzwaaij, Stephanie Van Biervliet, Thalia Z. Hummel, Zehre Yuksel, Gieneke Gonera-de Jong, Renate Schulenberg, Anneke Muller Kobold, and Patrick Ferry van Rheenen. 2018. “Predicting Inflammatory Bowel Disease in Children with Abdominal Pain and Diarrhoea : calgranulin-C Versus Calprotectin Stool Tests.” Archives of Disease in Childhood 103 (6): 565–571.
Chicago author-date (all authors)
Heida, Anke, Els Van de Vijver, Don van Ravenzwaaij, Stephanie Van Biervliet, Thalia Z. Hummel, Zehre Yuksel, Gieneke Gonera-de Jong, Renate Schulenberg, Anneke Muller Kobold, and Patrick Ferry van Rheenen. 2018. “Predicting Inflammatory Bowel Disease in Children with Abdominal Pain and Diarrhoea : calgranulin-C Versus Calprotectin Stool Tests.” Archives of Disease in Childhood 103 (6): 565–571.
Vancouver
1.
Heida A, Van de Vijver E, van Ravenzwaaij D, Van Biervliet S, Hummel TZ, Yuksel Z, et al. Predicting inflammatory bowel disease in children with abdominal pain and diarrhoea : calgranulin-C versus calprotectin stool tests. ARCHIVES OF DISEASE IN CHILDHOOD. 2018;103(6):565–71.
IEEE
[1]
A. Heida et al., “Predicting inflammatory bowel disease in children with abdominal pain and diarrhoea : calgranulin-C versus calprotectin stool tests,” ARCHIVES OF DISEASE IN CHILDHOOD, vol. 103, no. 6, pp. 565–571, 2018.
@article{8565375,
  abstract     = {Objective: Calgranulin-C (S100A12) is a new faecal marker of inflammation that is potentially more specific for inflammatory bowel disease (IBD) than calprotectin, since it is only released by activated granulocytes. We compared calgranulin-C and calprotectin to see which of the two tests best predicted IBD in children with chronic abdominal pain and diarrhoea. 
Design: Delayed-type cross-sectional diagnostic study. Setting and patients Previously undiagnosed patients aged 6-17years, who were seen in paediatric clinics in the Netherlands and Belgium, sent in a stool sample for analysis. Patients with a high likelihood of IBD underwent upper and lower endoscopy (ie, preferred reference test), while those with a low likelihood were followed for 6 months for latent IBD to become visible (ie, alternative reference test). We used Bayesian modelling to correct for differential verification bias. 
Main outcome measures: Primary outcome was the specificity for IBD using predefined test thresholds (calgranulin-C: 0.75 mu g/g, calprotectin: 50 mu g/g). Secondary outcome was the test accuracy with thresholds based on receiver operating characteristics (ROC) analysis. 
Results: IBD was diagnosed in 93 of 337 patients. Calgranulin-C had significantly better specificity than calprotectin when predefined thresholds were used (97% (95% credible interval (Cl) 94% to 99%) vs 71% (95% Cl 63% to 79%), respectively). When ROC-based thresholds were used (calgranulin-C: 0.75 mu g/g, calprotectin: 400 mu g/g), both tests performed equally well (specificity: 97% (95% Cl 94% to 99%) vs 98% (95% Cl 95% to 100%)). 
Conclusions: Both calgranulin-C and calprotectin have excellent test characteristics to predict IBD and justify endoscopy.},
  author       = {Heida, Anke and Van de Vijver, Els and van Ravenzwaaij, Don and Van Biervliet, Stephanie and Hummel, Thalia Z. and Yuksel, Zehre and Gonera-de Jong, Gieneke and Schulenberg, Renate and Kobold, Anneke Muller and van Rheenen, Patrick Ferry},
  issn         = {0003-9888},
  journal      = {ARCHIVES OF DISEASE IN CHILDHOOD},
  keywords     = {FECAL CALPROTECTIN,DIAGNOSTIC-ACCURACY,NONINVASIVE MARKER,S100A12},
  language     = {eng},
  number       = {6},
  pages        = {565--571},
  title        = {Predicting inflammatory bowel disease in children with abdominal pain and diarrhoea : calgranulin-C versus calprotectin stool tests},
  url          = {http://dx.doi.org/10.1136/archdischild-2017-314081},
  volume       = {103},
  year         = {2018},
}

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