Can Infection Impair the Diagnostic Level of Fecal Calprotectin in Patients with Inflammatory Bowel Disease? A Case Report

Overview

Journal Iran J Parasitol

Publisher Tehran University of Medical Sciences

Specialty Parasitology

Date 2018 Nov 29

PMID 30483345

Authors

Sara Mohammad Ali Gol

Hamed Mirjalali

Hamid Asadzadeh Aghdaei

Mohammad Reza Zali

Affiliations

Soon will be listed here.

Abstract

Inflammatory bowel disease (IBD) is attributed to complex conditions of gastrointestinal tract that is frequently reported all over the world. Fecal calprotectin evaluation is described as a primary tool to screen IBD patients. There are reports showing the confounding role of some microbial agents in diagnostic levels of calprotectin. A 32-yr-old woman with symptoms like IBD/IBS (irritable bowel syndrome); admitted to IBD Clinic of Behbood Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Jan 2017 for evaluation of the level of fecal calprotectin. In spite of high level of calprotectin, trophozoite of was observed in direct examination of stool sample. Microbial pathogens can lead to false elevation of fecal calprotectin and misdiagnosis of gastrointestinal patients suspected to IBD.

References

Lee J . [Fecal Calprotectin in Inflammatory Bowel Disease]. Korean J Gastroenterol. 2016; 67(5):233-7. DOI: 10.4166/kjg.2016.67.5.233. View

Hosseini S, Jafari P, Taghavi S, Safarpour A, Rezaianzadeh A, Moini M . Fecal Calprotectin is an Accurate Tool and Correlated to Seo Index in Prediction of Relapse in Iranian Patients With Ulcerative Colitis. Iran Red Crescent Med J. 2015; 17(2):e22796. PMC: 4353186. DOI: 10.5812/ircmj.22796. View

Hanevik K, Hausken T, Morken M, Strand E, Morch K, Coll P . Persisting symptoms and duodenal inflammation related to Giardia duodenalis infection. J Infect. 2007; 55(6):524-30. DOI: 10.1016/j.jinf.2007.09.004. View

El-Gayar E, Mokhtar A, Hassan W . Study of the pathogenic potential of in experimentally infected mice. Parasite Epidemiol Control. 2018; 1(2):136-143. PMC: 5991847. DOI: 10.1016/j.parepi.2016.05.002. View

Matowicka-Karna J . Markers of inflammation, activation of blood platelets and coagulation disorders in inflammatory bowel diseases. Postepy Hig Med Dosw (Online). 2016; 70:305-12. DOI: 10.5604/17322693.1199305. View

Johne B, Kronborg O, Ton H, Kristinsson J, Fuglerud P . A new fecal calprotectin test for colorectal neoplasia. Clinical results and comparison with previous method. Scand J Gastroenterol. 2001; 36(3):291-6. View

Feng Y, Xiao L . Zoonotic potential and molecular epidemiology of Giardia species and giardiasis. Clin Microbiol Rev. 2011; 24(1):110-40. PMC: 3021202. DOI: 10.1128/CMR.00033-10. View

Munasinghe V, Vella N, Ellis J, Windsor P, Stark D . Cyst formation and faecal-oral transmission of Dientamoeba fragilis--the missing link in the life cycle of an emerging pathogen. Int J Parasitol. 2013; 43(11):879-83. DOI: 10.1016/j.ijpara.2013.06.003. View

Kuzehkanani A, Rezaei S, Babaei Z, Niyyati M, Hashemi S, Rezaeian M . Enteric protozoan parasites in rural areas of bandar-abbas, southern iran: comparison of past and present situation. Iran J Public Health. 2012; 40(1):80-5. PMC: 3481726. View

10.

Safarpour A, Hosseini S, Mehrabani D . Epidemiology of inflammatory bowel diseases in iran and Asia; a mini review. Iran J Med Sci. 2013; 38(2 Suppl):140-9. PMC: 3771215. View

11.

Hatam-Nahavandi K, Mohebali M, Mahvi A, Keshavarz H, Mirjalali H, Rezaei S . Subtype analysis of Giardia duodenalis isolates from municipal and domestic raw wastewaters in Iran. Environ Sci Pollut Res Int. 2016; 24(14):12740-12747. DOI: 10.1007/s11356-016-6316-y. View

12.

Sarkari B, Hosseini G, Motazedian M, Fararouei M, Moshfe A . Prevalence and risk factors of intestinal protozoan infections: a population-based study in rural areas of Boyer-Ahmad district, Southwestern Iran. BMC Infect Dis. 2016; 16(1):703. PMC: 5123427. DOI: 10.1186/s12879-016-2047-4. View

13.

Konikoff M, Denson L . Role of fecal calprotectin as a biomarker of intestinal inflammation in inflammatory bowel disease. Inflamm Bowel Dis. 2006; 12(6):524-34. DOI: 10.1097/00054725-200606000-00013. View

14.

Tibble J, Sigthorsson G, Foster R, Scott D, Fagerhol M, Roseth A . High prevalence of NSAID enteropathy as shown by a simple faecal test. Gut. 1999; 45(3):362-6. PMC: 1727647. DOI: 10.1136/gut.45.3.362. View

15.

Zahedi M, Darvish Moghadam S, Hayat Bakhsh Abbasi M, Dehghani M, Shafiei Pour S, Zydabady Nejad H . The incidence rate of inflammatory bowel disease in an urban area of iran: a developing country. Middle East J Dig Dis. 2014; 6(1):32-6. PMC: 4005476. View

16.

Esch K, Petersen C . Transmission and epidemiology of zoonotic protozoal diseases of companion animals. Clin Microbiol Rev. 2013; 26(1):58-85. PMC: 3553666. DOI: 10.1128/CMR.00067-12. View

17.

Bustinduy A, Sousa-Figueiredo J, Adriko M, Betson M, Fenwick A, Kabatereine N . Fecal occult blood and fecal calprotectin as point-of-care markers of intestinal morbidity in Ugandan children with Schistosoma mansoni infection. PLoS Negl Trop Dis. 2013; 7(11):e2542. PMC: 3828154. DOI: 10.1371/journal.pntd.0002542. View

18.

Duman M, Gencpinar P, Bicmen M, Arslan N, Ozden O, Uzum O . Fecal calprotectin: can be used to distinguish between bacterial and viral gastroenteritis in children?. Am J Emerg Med. 2015; 33(10):1436-9. DOI: 10.1016/j.ajem.2015.07.007. View

19.

Malekzadeh M, Vahedi H, Gohari K, Mehdipour P, Sepanlou S, Ebrahimi Daryani N . Emerging Epidemic of Inflammatory Bowel Disease in a Middle Income Country: A Nation-wide Study from Iran. Arch Iran Med. 2015; 19(1):2-15. DOI: 0161901/AIM.003. View

20.

Rayani M, Unyah N, Hatam G . Molecular Identification of Giardia duodenalis Isolates from Fars Province, Iran. Iran J Parasitol. 2015; 9(1):70-8. PMC: 4289883. View