The Role of Fecal Calprotectin in The Diagnosis and Severity of Ulcerative Colitis
Keywords:
Fecal Calprotectin, Inflammatory Bowel Disease, Ulcerative ColitisAbstract
Background: The neutrophil-derived protein fecal calprotectin has emerged over the last decade as a novel non-invasive biomarker for the diagnosis and follow-up of intestinal inflammation. Objectives The objective of this study was to assess the diagnostic power and role of severity of fecal calprotectin in patients with ulcerative colitis.
Methods: A case-control study was performed in Al-Najaf City in Iraq at Al-Sadr Medical City, from August 2025 to March 2026. A total of 150 subjects were recruited, comprising 63 patients with clinicopathologically proved ulcerative colitis (UC) and 87 apparently healthy controls. The severity of disease was characterized according to the Mayo scoring system into mild, moderate and severe. All subjects were asked to provide fresh stool samples, and fecal calprotectin concentrations were assessed via a commercially available ELISA. Results: Fecal calprotectin concentrations in patients with ulcerative colitis were significantly greater than those of healthy controls (412.68 ± 136.45 μg/g vs.38.74 ± 14.62 μg/g; p <0.002). Similarly, fecal calprotectin concentration showed stepwise elevation according to disease severity: 218.54 ± 64.27μg/g, 431.86 ± 95.48μg/g and 732.45 ± 128.91μg/g in patients with mild, moderate and severe disease respectively (F =58·73, p <0·001). In the diagnosis of ulcerative colitis, fecal calprotectin showed a sensitivity of 90.5% and specificity of 87.4% at a cut-off value of 85.5 μg/g. Conclusions: Fecal calprotectin stands as a non-invasive biomarker with high sensibility and specificity in the diagnosis of ulcerative colitis, also correlating highly with severity of illness. The sequential accumulation of high fecal calprotectin concentrations with severe disease activity is a further indication of its useful e ness as an indicator of inflammatory burden, which is directly related to treatment choices.
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