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Elevated fecal levels of eosinophil granule proteins predict collagenous colitis in patients referred to colonoscopy due to chronic non-bloody diarrhea
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Upper Abdominal Surgery.
Lund Univ, Skane Univ Hosp, Dept Gastroenterol & Nutr, Dept Clin Sci, Malmo, Sweden..
Ystad Hosp, Dept Med, Ystad, Sweden..
Univ Malmo, Dept Pathol, Malmo, Sweden.;Skane Univ Hosp, Reg Labs Reg Skane, Malmo, Sweden..
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2016 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 51, no 7, 835-841 p.Article in journal (Refereed) PublishedText
Abstract [en]

Objective: Colonoscopy with biopsy sampling is often performed to detect collagenous colitis (CC) and lymphocytic colitis (LC) in patients with chronic non-bloody diarrhea. However, the diagnostic yield is low and incurs high costs. Fecal calprotectin (FC) and myeloperoxidase (MPO) indicate intestinal inflammation in ulcerative colitis (UC) and Crohn's disease (CD). In CC, elevated fecal levels of eosinophil protein X (EPX) and eosinophil cationic protein (ECP) have been reported. We aimed to evaluate if F-EPX, F-ECP, FC, and F-MPO could predict the diagnostic outcome in patients with chronic non-bloody diarrhea referred to colonoscopy. We also evaluated serum (S) EPX and ECP in this regard. Methods: Of 67 included patients, 63 (94%) underwent colonoscopy with biopsy sampling. Fecal EPX, F-ECP, FC, F-MPO, S-EPX, and S-ECP were analyzed. Results: Diagnostic outcome: normal: n = 46 (73%), CC: n = 9 (14%), LC: n = 4 (6%), UC: n = 2 (3%), CD: n = 2 (3%). Higher levels of F-EPX and F-ECP were found in CC compared to a normal diagnostic outcome (p = 0.01). No change was noted in any of the fecal markers in LC. When all of the fecal markers were normal the probability of a normal diagnostic outcome was 92%. We found no differences in S-EPX and S-ECP between the groups. Conclusion: Elevated F-EPX and F-ECP could predict CC. None of the fecal markers predicted LC. Serum-EPX and S-ECP are not useful for the diagnosis of CC, LC, UC, or CD. With normal levels in all of the analyzed fecal markers, there is a low probability of a pathologic diagnostic outcome.

Place, publisher, year, edition, pages
2016. Vol. 51, no 7, 835-841 p.
Keyword [en]
Collagenous colitis, eosinophil, eosinophil cationic protein, eosinophil protein X, fecal markers
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:uu:diva-299533DOI: 10.3109/00365521.2016.1141432ISI: 000377451400010PubMedID: 26854205OAI: oai:DiVA.org:uu-299533DiVA: diva2:949647
Funder
Stiftelsen Olle Engkvist Byggmästare
Available from: 2016-07-22 Created: 2016-07-22 Last updated: 2016-07-22Bibliographically approved

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