Role of Fecal Calprotectin in Differentiating between Hirschsprung's Disease and Functional Constipation

Fatemeh Elham Mahjoub; Nasim Zahedi; Bahar Ashjai; Mohammad Taghi Haghi Ashtiani; Fatemeh Farahmand; Maryam Monajemzadeh; Leila Kashi; Heshmat Iranikhah

doi:10.4166/kjg.2013.62.5.288

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Mahjoub, Zahedi, Ashjai, Ashtiani, Farahmand, Monajemzadeh, Kashi, and Iranikhah: Role of Fecal Calprotectin in Differentiating between Hirschsprung's Disease and Functional Constipation

Original Article

Korean J Gastroenterol 2013;62(5):288-291.

Published online: 4 October 2013

DOI: https://doi.org/10.4166/kjg.2013.62.5.288

Role of Fecal Calprotectin in Differentiating between Hirschsprung's Disease and Functional Constipation

Fatemeh Elham Mahjoub^1,², Nasim Zahedi¹, Bahar Ashjai³, Mohammad Taghi Haghi Ashtiani¹, Fatemeh Farahmand⁴, Maryam Monajemzadeh¹, Leila Kashi⁵, Heshmat Iranikhah⁵

¹Department of Pathology, Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran

²Maternal, Fetal and Neonatal Research Center, Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran

³Pediatric Surgery, Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran

⁴Pediatric Gastroenterology, Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran

⁵Microbiology and Laboratory Sciences, Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran

Correspondence to: Fatemeh Elham Mahjoub, Department of Pathology, Central Laboratory, Valiasr Hospital, Imam Khomeini Hospital Complex, End of Keshavarz Boulevard 1419733141, Tehran, Iran. Tel: +98-21-61192320, Fax: +98-21-61192345, E-mail: fmahjoub@sina.tums.ac.ir

Received 7 May 2013 Revised 8 September 2013 Accepted 24 September 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

Calprotectin is a 36.5 kD calcium and zinc binding protein in the S100 protein family. Fecal calprotectin levels are elevated in patients with inflammatory bowel disease and some other gastrointestinal disorders such as colorectal carcinoma. We decided to evaluate the fecal calprotectin level to see if it was able to distinguish between functional and organic causes of constipation.

Methods

Seventy-six children aged 1 to 120 months that all underwent deep rectal mucosa biopsies at Children Medical Center from November 2010 till September 2011 were recruited. Nineteen cases were diagnosed as Hirschsprung's disease and 57 of the patients had nerve ganglion cells in their biopsies. Calprotectin concentration was analyzed by the ELISA method.

Results

Although there was a significant difference between the median of the two groups (p=0.036), the median was not above the predetermined cutoff value of 50 μg/g.

Conclusions

We propose that fecal calprotectin, using the above cutoff value, has limited value in differentiating functional constipation from Hirschsprung's disease.

Keywords: Constipation, Hirschsprung disease, Calprotectin, Feces, Pediatrics

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Fig. 1.

Box plot of fecal calprotectin concentration in children with functional constipation (group A, n=57) and Hirschsprung's disease (group B, n=19).

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