perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2023-68-5-138-143perinatology-1889Research ArticleВ ПОМОЩЬ ПРАКТИЧЕСКОМУ ВРАЧУGUIDELINES FOR THE PRACTITIONERФекальный кальпротектин как маркер воспалительных заболеваний кишечникаFecal calprotectin as a marker of inflammatory bowel diseaseshttps://orcid.org/0000-0002-2957-680XКамаловаА. А.KamalovaA. A.

Камалова Аэлита Асхатовна — д.м.н., проф. кафедры госпитальной педиатрии 

420012 Казань, ул. Бутлерова, д. 49

Kazan

aelitakamalova@gmail.comhttps://orcid.org/0000-0002-4333-8779ГаринаГ. А.GarinaG. A.

Гарина Галина Алексеевна — асп. кафедры госпитальной педиатрии 

420012 Казань, ул. Бутлерова, д. 49

Kazan

https://orcid.org/0000-0003-3707-6511ВалееваИ. Х.ValeevaI. Kh.

Валеева Илдария Хайрулловна — д.б.н., ст. науч. сотр. Центральной научно-исследовательской лаборатории 

420012 Казань, ул. Бутлерова, д. 49

Kazan

https://orcid.org/0000-0002-1835-5649ГайфутдиноваА. Р.GaifutdinovaA. R.

Гайфутдинова Алия Ринатовна — асп. кафедры госпитальной педиатрии 

420012 Казань, ул. Бутлерова, д. 49

Kazan

ФГБОУ ВО «Казанский государственный медицинский университет» Минздрава РоссииРоссияKazan State Medical UniversityRussian Federation202316112023685138143Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20232023Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/1889

Кальпротектин — это кальций- и цинксвязывающий белок, относящийся к семейству белков S100. Этот белок находится преимущественно в цитоплазме нейтрофилов и в меньшей степени в моноцитах и макрофагах, которые могут быть обнаружены в любых органах человека, но преимущественно в крови, спинномозговой жидкости, кале, слюне и синовиальной жидкости. Кальпротектин представляет собой эффективный маркер для дифференциальной диагностики воспалительных заболеваний кишечника и синдрома раздраженного кишечника. Существует связь фекального кальпротектина с эндоскопической активностью воспалительных заболеваний кишечника, однако в доступной литературе имеются значительные различия данных чувствительности и специфичности фекального кальпротектина для прогнозирования эндоскопической активности заболевания. Помимо этого, фекальный кальпротектин можно рассматривать в качестве предиктора гистологического заживления слизистой оболочки и в качестве маркера для оценки ответа на лечение, в том числе хирургическое. Однако до сих пор не существует единого мнения о пороговом значении биомаркера для этих целей. Противоречивые данные представлены в отчетах о фекальном кальпротектине как предикторе рецидива воспалительных заболеваний кишечника. Этот маркер представляется эффективным для выявления рецидива, но нет конкретного порогового значения, следовательно, определение этого маркера не может полностью заменить эндоскопические методы исследования. Кроме того, отмечается внутрииндивидуальная вариабельность концентрации фекального кальпротектина у пациентов, зависящая от возраста, вида вскармливания на первом году жизни, приема препаратов, что значительно затрудняет интерпретацию результатов.

Calprotectin is a calcium- and zinc-binding protein belonging to the S100 protein family. This protein is found mainly in the cytoplasm of neutrophils, and, to a lesser extent, in monocytes and macrophages, which can be found in any human organs, but mainly in blood, cerebrospinal fluid, feces, saliva, and synovial fluid. Calprotectin is an effective tool forthe differential diagnosis of inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). There is a connection of fecal calprotectin (FC) with the endoscopic activity of IBD, however, the available literature shows significant differences in the sensitivity and specificity of FC for predicting the endoscopic activity of the disease. In addition, FC can be considered as a predictor of histological mucosal healing and as a marker for assessing the response to treatment, including surgical, but there is still no consensus on the threshold value of a biomarker for these purposes. Conflicting data are presented in reports on FC as a predictor of IBD recurrence. FC seems to be effective for detecting relapse, however, there is no specific threshold value, therefore, the marker cannot completely replace endoscopic examination methods. In addition, there is intraindividual variability in the concentration of FC in patients, depending on age, type of feeding in the first year of life, taking medications, which significantly complicates the interpretation of the results.

детикальпротектинчувствительностьспецифичностьвоспалительные заболевания кишечникаchildrencalprotectinsensitivityspecificityinflammatory bowel diseasesReferencesNaess-Andresen C.F., Egelandsdal B., Fagerhol M.K. Calcium binding and concomitant changes in the structure and heat stability of calprotectin (L1 protein). Clin Mol Pathol 1995; 48: 278–284. DOI: 10.1136/mp.48.5.m278Naess-Andresen C.F., Egelandsdal B., Fagerhol M.K. Calcium binding and concomitant changes in the structure and heat stability of calprotectin (L1 protein). Clin Mol Pathol 1995; 48: 278–284. DOI: 10.1136/mp.48.5.m278Haisma S.M., van Rheenen P.F., Wagenmakers L., Muller K.A. Calprotectin instability may lead to undertreatment in children with IBD. Arch Dis Child 2019; 105: 1–3. DOI: 10.1136/archdischild-2018–316584Haisma S.M., van Rheenen P.F., Wagenmakers L., Muller K.A. Calprotectin instability may lead to undertreatment in children with IBD. Arch Dis Child 2019; 105: 1–3. DOI: 10.1136/archdischild-2018–316584Oyaert M., Van den Bremt S., Boel A., Bossuyt X., Van Hoovels L. Do not forget about pre-analytics in faecal calprotectin measurement! Clin Chim Acta 2017; 473:124–126. DOI: 10.1016/j.cca.2017.08.025Oyaert M., Van den Bremt S., Boel A., Bossuyt X., Van Hoovels L. Do not forget about pre-analytics in faecal calprotectin measurement! Clin Chim Acta 2017; 473:124–126. DOI: 10.1016/j.cca.2017.08.025Roseth A.G., Fagerhol M.K., Aadland E., Schjonsby H. Assessment of the neutrophil dominating protein calprotectin in feces. A methodologic study. Scand J Gastroenterol 1992; 27: 793–798. DOI: 10.3109/00365529209011186Roseth A.G., Fagerhol M.K., Aadland E., Schjonsby H. Assessment of the neutrophil dominating protein calprotectin in feces. A methodologic study. Scand J Gastroenterol 1992; 27: 793–798. DOI: 10.3109/00365529209011186Roseth A.G., Aadland E., Jahnsen J., Raknerud N. Assessment of disease activity in ulcerative colitis by faecal calprotectin, a novel granulocyte marker protein. Digestion 1997; 58: 176–180. DOI: 10.1159/000201441Roseth A.G., Aadland E., Jahnsen J., Raknerud N. Assessment of disease activity in ulcerative colitis by faecal calprotectin, a novel granulocyte marker protein. Digestion 1997; 58: 176–180. DOI: 10.1159/000201441Levine A., Turner D., Pfeffer Gik T., Amil Dias J., Veres G., Shaoul R. et al. Comparison of outcomes parameters for induction of remission in New Onset Pediatric Crohn’s Disease: evaluation of the Porto IBD Group «Growth Relapse and Outcomes with Therapy» (GROWTH CD) Study. Inflamm Bowel Dis 2014; 20: 278–285. DOI: 10.1097/01.MIB.0000437735.11953.68Levine A., Turner D., Pfeffer Gik T., Amil Dias J., Veres G., Shaoul R. et al. Comparison of outcomes parameters for induction of remission in New Onset Pediatric Crohn’s Disease: evaluation of the Porto IBD Group «Growth Relapse and Outcomes with Therapy» (GROWTH CD) Study. Inflamm Bowel Dis 2014; 20: 278–285. DOI: 10.1097/01.MIB.0000437735.11953.68Degraeuwe P.L., Beld M.P., Ashorn M., Canani R.B., Day A.S., Diamanti A. et al. Faecal calprotectin in suspected paediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2015; 60: 339. DOI: 10.1097/MPG.0000000000000615Degraeuwe P.L., Beld M.P., Ashorn M., Canani R.B., Day A.S., Diamanti A. et al. Faecal calprotectin in suspected paediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2015; 60: 339. DOI: 10.1097/MPG.0000000000000615Khaki-Khatibi F., Qujeq D., Kashifard M., Moein S., Maniati M., Vaghari-Tabari M. Calprotectin in inflammatory bowel disease. Clin Chim Acta 2020; 510: 556–565. DOI: 10.1016/j.cca.2020.08.025Khaki-Khatibi F., Qujeq D., Kashifard M., Moein S., Maniati M., Vaghari-Tabari M. Calprotectin in inflammatory bowel disease. Clin Chim Acta 2020; 510: 556–565. DOI: 10.1016/j.cca.2020.08.025Menees S.B., Powell C., Kurlander J., Goel A., Chey W.D. A meta-analysis of the utility of C-reactive protein, erythrocyte sedimentation rate, fecal calprotectin, and fecal lactoferrin to exclude inflammatory bowel disease in adults with IBS. Am J Gastroenterol 2015; 110: 444–454. DOI: 10.1038/ajg.2015.6Menees S.B., Powell C., Kurlander J., Goel A., Chey W.D. A meta-analysis of the utility of C-reactive protein, erythrocyte sedimentation rate, fecal calprotectin, and fecal lactoferrin to exclude inflammatory bowel disease in adults with IBS. Am J Gastroenterol 2015; 110: 444–454. DOI: 10.1038/ajg.2015.6Клинические рекомендации Министерства здравоохранения РФ. Язвенный колит. Утверждены Министерством здравоохранения РФ в 2021 году. Одобрены Научно-практическим советом Минздрава РФ. 2021: 17. https://www.pediatr-russia.ru/information/klin-rek/proekty-klinicheskikh-rekomendatsiy/ЯК%20дети%201.06.2021.pdf / Ссылка активна на 03.08.2023.Clinical recommendations of the Ministry of Health of the Russian Federation. Ulcerative colitis. Approved by the Ministry of Health of the Russian Federation in 2021. Approved by the Scientific and Practical Council of the Ministry of Health of the Russian Federation. 2021: 17. (in Russ.)Roseth A.G., Aadland E., Grzyb K. Normalization of faecal calprotectin: a predictor of mucosal healing in patients with inflammatory bowel disease. Scand J Gastroenterol 2004; 39: 1017–1020. DOI: 10.1080/00365520410007971Roseth A.G., Aadland E., Grzyb K. Normalization of faecal calprotectin: a predictor of mucosal healing in patients with inflammatory bowel disease. Scand J Gastroenterol 2004; 39: 1017–1020. DOI: 10.1080/00365520410007971Sipponen T., Savilahti E., Kolho K.L., Nuutinen H., Turunen U., Färkkilä M. Crohn’s disease activity assessed by fecal calprotectin and lactoferrin: correlation with Crohn’s disease activity index and endoscopic findings. Inflamm Bowel Dis 2008; 14: 40–46. DOI: 10.1002/ibd.20312Sipponen T., Savilahti E., Kolho K.L., Nuutinen H., Turunen U., Färkkilä M. Crohn’s disease activity assessed by fecal calprotectin and lactoferrin: correlation with Crohn’s disease activity index and endoscopic findings. Inflamm Bowel Dis 2008; 14: 40–46. DOI: 10.1002/ibd.20312Vieira A., Fang C.B., Rolim E.G., Klug W.A., Steinwurz F., Rossini L. et al. Inflammatory bowel disease activity assessed by fecal calprotectin and lactoferrin: correlation with laboratory parameters, clinical, endoscopic and histological indexes. BMC Res Notes 2009; 2: 221. DOI: 10.1186/1756–0500–2–221Vieira A., Fang C.B., Rolim E.G., Klug W.A., Steinwurz F., Rossini L. et al. Inflammatory bowel disease activity assessed by fecal calprotectin and lactoferrin: correlation with laboratory parameters, clinical, endoscopic and histological indexes. BMC Res Notes 2009; 2: 221. DOI: 10.1186/1756–0500–2–221Melmed G.Y., Dubinsky M.C., Rubin D.T., Fleisher M., Pasha S.F., Sakuraba A. et al. Utility of video capsule endoscopy for longitudinal monitoring of Crohn’s disease activity in the small bowel: a prospective study. Gastrointest Endosc 2018; 88: 947–955. DOI: 10.1016/j.gie.2018.07.035Melmed G.Y., Dubinsky M.C., Rubin D.T., Fleisher M., Pasha S.F., Sakuraba A. et al. Utility of video capsule endoscopy for longitudinal monitoring of Crohn’s disease activity in the small bowel: a prospective study. Gastrointest Endosc 2018; 88: 947–955. DOI: 10.1016/j.gie.2018.07.035Egea Valenzuela J., Pereñíguez López A., Pérez Fernández V., Alberca de Las Parras F., Carballo Álvarez F. Fecal calprotectin and C-reactive protein are associated with positive findings in capsule endoscopy in suspected small bowel Crohn’s disease. Rev Esp Enferm Dig 2016; 108: 394–400. DOI: 10.17235/reed.2016.4318/2016Egea Valenzuela J., Pereñíguez López A., Pérez Fernández V., Alberca de Las Parras F., Carballo Álvarez F. Fecal calprotectin and C-reactive protein are associated with positive findings in capsule endoscopy in suspected small bowel Crohn’s disease. Rev Esp Enferm Dig 2016; 108: 394–400. DOI: 10.17235/reed.2016.4318/2016Theede K., Holck S., Ibsen P., Ladelund S., Nordgaard-Lassen I., Nielsen A.M. Level of fecal calprotectin correlates with endoscopic and histologic inflammation and identifies patients with mucosal healing in ulcerative colitis. Clin Gastroenterol Hepatol 2015; 13: 1929–1936. DOI: 10.1016/j.cgh.2015.05.038Theede K., Holck S., Ibsen P., Ladelund S., Nordgaard-Lassen I., Nielsen A.M. Level of fecal calprotectin correlates with endoscopic and histologic inflammation and identifies patients with mucosal healing in ulcerative colitis. Clin Gastroenterol Hepatol 2015; 13: 1929–1936. DOI: 10.1016/j.cgh.2015.05.038Walsh A., Kormilitzin A., Hinds C., Sexton V., Brain O., Keshav S. et al. Defining faecal calprotectin thresholds as a surrogate for endoscopic and histological disease activity in ulcerative colitis-a prospective analysis. J Crohns Colitis 2019; 13: 424–430. DOI: 10.1093/ecco-jcc/jjy184Walsh A., Kormilitzin A., Hinds C., Sexton V., Brain O., Keshav S. et al. Defining faecal calprotectin thresholds as a surrogate for endoscopic and histological disease activity in ulcerative colitis-a prospective analysis. J Crohns Colitis 2019; 13: 424–430. DOI: 10.1093/ecco-jcc/jjy184Molander P., af Björkesten C.G., Mustonen H., Haapamäki J., Vauhkonen M., Kolho K.L. et al. Fecal calprotectin concentration predicts outcome in inflammatory bowel disease after induction therapy with TNFalpha blocking agents. Inflamm Bowel Dis 2012; 18: 2011–2017. DOI: 10.1002/ibd.22863Molander P., af Björkesten C.G., Mustonen H., Haapamäki J., Vauhkonen M., Kolho K.L. et al. Fecal calprotectin concentration predicts outcome in inflammatory bowel disease after induction therapy with TNFalpha blocking agents. Inflamm Bowel Dis 2012; 18: 2011–2017. DOI: 10.1002/ibd.22863Hamalainen A., Sipponen T., Kolho K.L. Infliximab in pediatric inflammatory bowel disease rapidly decreases fecal calprotectin levels. World J Gastroenterol 2011; 17: 5166–5171. DOI: 10.3748/wjg.v17.i47.5166Hamalainen A., Sipponen T., Kolho K.L. Infliximab in pediatric inflammatory bowel disease rapidly decreases fecal calprotectin levels. World J Gastroenterol 2011; 17: 5166–5171. DOI: 10.3748/wjg.v17.i47.5166Sipponen T., Kolho K. Faecal calprotectin in children with clinically quiescent inflammatory bowel disease. Scand J Gastroenterol 2010; 45: 872–877. DOI: 10.3109/00365521003782389Sipponen T., Kolho K. Faecal calprotectin in children with clinically quiescent inflammatory bowel disease. Scand J Gastroenterol 2010; 45: 872–877. DOI: 10.3109/00365521003782389Amil-Dias J., Kolacek S., Turner D., Pærregaard A., Rintala R., Afzal N.A. et al. IBD Working Group of ESPGHAN (IBD Porto Group). Surgical management of Crohn disease in children: guidelines from the paediatric IBD Porto Group of ESPGHAN. J Pediatr Gastroenterol Nutr 2017; 64: 818–835. DOI: 10.1097/MPG.0000000000001562Amil-Dias J., Kolacek S., Turner D., Pærregaard A., Rintala R., Afzal N.A. et al. IBD Working Group of ESPGHAN (IBD Porto Group). Surgical management of Crohn disease in children: guidelines from the paediatric IBD Porto Group of ESPGHAN. J Pediatr Gastroenterol Nutr 2017; 64: 818–835. DOI: 10.1097/MPG.0000000000001562Tibble J.A., Sigthorsson G., Bridger S., Fagerhol M.K., Bjarnason I. Surrogate markers of intestinal inflammation are predictive of relapse in patients with inflammatory bowel disease. Gastroenterology 2000; 119: 15–22. DOI: 10.1053/gast.2000.8523Tibble J.A., Sigthorsson G., Bridger S., Fagerhol M.K., Bjarnason I. Surrogate markers of intestinal inflammation are predictive of relapse in patients with inflammatory bowel disease. Gastroenterology 2000; 119: 15–22. DOI: 10.1053/gast.2000.8523Costa F., Mumolo M.G., Ceccarelli L., Bellini M., Romano M.R., Sterpi C. et al. Calprotectin is a stronger predictive marker of relapse in ulcerative colitis than in Crohn’s disease. Gut 2005; 54: 364–368. DOI: 10.1136/gut.2004.043406Costa F., Mumolo M.G., Ceccarelli L., Bellini M., Romano M.R., Sterpi C. et al. Calprotectin is a stronger predictive marker of relapse in ulcerative colitis than in Crohn’s disease. Gut 2005; 54: 364–368. DOI: 10.1136/gut.2004.043406Laharie D., Mesli S., El Hajbi F., Chabrun E., Chanteloup E., Capdepont M. et al. Prediction of Crohn’s disease relapse with faecal calprotectin in infliximab responders: a prospective study. Aliment Pharmacol Ther 2011; 34: 462–469. DOI: 10.1111/j.1365–2036.2011.04778.xLaharie D., Mesli S., El Hajbi F., Chabrun E., Chanteloup E., Capdepont M. et al. Prediction of Crohn’s disease relapse with faecal calprotectin in infliximab responders: a prospective study. Aliment Pharmacol Ther 2011; 34: 462–469. DOI: 10.1111/j.1365–2036.2011.04778.xHart L., Chavannes M., Kherad O., Maedler C., Mourad N., Marcus V. et al. Faecal calprotectin predicts endoscopic and histological activity in clinically quiescent ulcerative colitis. J Crohns Colitis 2019; 14: 46– 52. DOI: 10.1093/ecco-jcc/jjz107Hart L., Chavannes M., Kherad O., Maedler C., Mourad N., Marcus V. et al. Faecal calprotectin predicts endoscopic and histological activity in clinically quiescent ulcerative colitis. J Crohns Colitis 2019; 14: 46– 52. DOI: 10.1093/ecco-jcc/jjz107Li J., Zhao X., Li X., Lu M., Zhang H. Systematic review with meta-analysis: fecal calprotectin as a surrogate marker for predicting relapse in adults with ulcerative colitis. Mediators Inflamm 2019; 28: 11. DOI: 10.1155/2019/2136501Li J., Zhao X., Li X., Lu M., Zhang H. Systematic review with meta-analysis: fecal calprotectin as a surrogate marker for predicting relapse in adults with ulcerative colitis. Mediators Inflamm 2019; 28: 11. DOI: 10.1155/2019/2136501Ruemmele F.M., Veres G., Kolho K.L., Griffiths A., Levine A., Escher J.C. et al. European Crohn’s and Colitis Organisation, European Society of Pediatric Gastroenterology, Hepatology and Nutrition. Consensus guidelines of ECCO/ ESPGHAN on the medical management of pediatric Crohn’s disease. J Crohns Colitis 2014; 8: 1179–1207. DOI: 10.1016/j.crohns.2014.04.005Ruemmele F.M., Veres G., Kolho K.L., Griffiths A., Levine A., Escher J.C. et al. European Crohn’s and Colitis Organisation, European Society of Pediatric Gastroenterology, Hepatology and Nutrition. Consensus guidelines of ECCO/ ESPGHAN on the medical management of pediatric Crohn’s disease. J Crohns Colitis 2014; 8: 1179–1207. DOI: 10.1016/j.crohns.2014.04.005van Rheenen P.F., Aloi M., Assa A., Bronsky J., Escher J.C., Fagerberg U.L. et al. The medical management of paediatric Crohn’s disease: an ECCO-ESPGHAN Guideline Update. J Crohn’s Colitis 2020; 15: 171–194. DOI: 10.1093/ecco-jcc/jjaa161van Rheenen P.F., Aloi M., Assa A., Bronsky J., Escher J.C., Fagerberg U.L. et al. The medical management of paediatric Crohn’s disease: an ECCO-ESPGHAN Guideline Update. J Crohn’s Colitis 2020; 15: 171–194. DOI: 10.1093/ecco-jcc/jjaa161Kolho K., Alfthan H. Concentration of fecal calprotectin in 11,255 children aged 0–18 years. Scand J Gastroenterol 2020; 55: 1024–1027. DOI: 10.1080/00365521.2020.1794026Kolho K., Alfthan H. Concentration of fecal calprotectin in 11,255 children aged 0–18 years. Scand J Gastroenterol 2020; 55: 1024–1027. DOI: 10.1080/00365521.2020.1794026Turner D., Ruemmele F.M., Orlanski-Meyer E., Griffiths A.M., de Carpi J.M., Bronsky J. et al. Management of paediatric ulcerative colitis, part 2: acute severe colitis — an evidence-based Consensus Guideline From the European Crohn’s and Colitis Organization and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2018; 67: 292–310. DOI: 10.1097/MPG.0000000000002036Turner D., Ruemmele F.M., Orlanski-Meyer E., Griffiths A.M., de Carpi J.M., Bronsky J. et al. Management of paediatric ulcerative colitis, part 2: acute severe colitis — an evidence-based Consensus Guideline From the European Crohn’s and Colitis Organization and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2018; 67: 292–310. DOI: 10.1097/MPG.0000000000002036Moum B., Jahnsen J., T. Bernklev. Fecal calprotectin variability in Crohn’s disease. Inflamm Bowel Dis 2010; 16: 1091–1092. DOI: 10.1002/ibd.21136Moum B., Jahnsen J., T. Bernklev. Fecal calprotectin variability in Crohn’s disease. Inflamm Bowel Dis 2010; 16: 1091–1092. DOI: 10.1002/ibd.21136Meling T.R., Aabakken L., Røseth A., Osnes M. Faecal calprotectin shedding after short-term treatment with non-steroidal anti-inflammatory drugs. Scand J Gastroenterol 1996; 31: 339–344. DOI: 10.3109/00365529609006407Meling T.R., Aabakken L., Røseth A., Osnes M. Faecal calprotectin shedding after short-term treatment with non-steroidal anti-inflammatory drugs. Scand J Gastroenterol 1996; 31: 339–344. DOI: 10.3109/00365529609006407Poullis A., Foster R., Mendall M.A., Shreeve D., Wiener K. Proton pump inhibitors are associated with elevation of faecal calprotectin and may affect specificity. Eur J Gastroenterol Hepatol 2003; 15: 573–574. DOI: 10.1097/00042737–200305000–00021Poullis A., Foster R., Mendall M.A., Shreeve D., Wiener K. Proton pump inhibitors are associated with elevation of faecal calprotectin and may affect specificity. Eur J Gastroenterol Hepatol 2003; 15: 573–574. DOI: 10.1097/00042737–200305000–00021Kolho K. L., Alfthan H., Hamalainen E. Effect of bowel cleansing for colonoscopy on fecal calprotectin levels in pediatric patients. J Pediatr Gastroenterol Nutr 2012; 55: 751–753. DOI: 10.1097/MPG.0b013e31825f4c77Kolho K. L., Alfthan H., Hamalainen E. Effect of bowel cleansing for colonoscopy on fecal calprotectin levels in pediatric patients. J Pediatr Gastroenterol Nutr 2012; 55: 751–753. DOI: 10.1097/MPG.0b013e31825f4c77Alibrahim B., Aljasser M.I., Salh B. Fecal calprotectin use in inflammatory bowel disease and beyond: a mini-review. Can J Gastroenterol Hepatol 2015; 29: 157–163. DOI: 10.1155/2015/950286Alibrahim B., Aljasser M.I., Salh B. Fecal calprotectin use in inflammatory bowel disease and beyond: a mini-review. Can J Gastroenterol Hepatol 2015; 29: 157–163. DOI: 10.1155/2015/950286Fagerberg U.L., Lööf L., Merzoug R.D., Hansson L.O., Finkel Y. Fecal calprotectin levels in healthy children studied with an improved assay. J Pediatr Gastroenterol Nutr 2003; 37: 468–472. DOI: 10.1097/00005176–200310000–00013Fagerberg U.L., Lööf L., Merzoug R.D., Hansson L.O., Finkel Y. Fecal calprotectin levels in healthy children studied with an improved assay. J Pediatr Gastroenterol Nutr 2003; 37: 468–472. DOI: 10.1097/00005176–200310000–00013Olafsdottir E., Aksnes L., Fluge G., Berstad A. Faecal calprotectin levels in infants with infantile colic, healthy infants, children with inflammatory bowel disease, children with recurrent abdominal pain and healthy children. Acta Paediatr 2002; 91: 45–50. DOI: 10.1080/080352502753457932Olafsdottir E., Aksnes L., Fluge G., Berstad A. Faecal calprotectin levels in infants with infantile colic, healthy infants, children with inflammatory bowel disease, children with recurrent abdominal pain and healthy children. Acta Paediatr 2002; 91: 45–50. DOI: 10.1080/080352502753457932Zoppelli L., Güttel C., Bittrich H.J., Andrée C., Wirth S., Jenke A. Fecal calprotectin concentrations in premature infants have a lower limit and show postnatal and gestational age dependence. Neonatology 2012; 102: 68–74. DOI: 10.1159/000337841Zoppelli L., Güttel C., Bittrich H.J., Andrée C., Wirth S., Jenke A. Fecal calprotectin concentrations in premature infants have a lower limit and show postnatal and gestational age dependence. Neonatology 2012; 102: 68–74. DOI: 10.1159/000337841Josefsson S., Bunn S. K., Domellof M. Fecal calprotectin in very low birth weight infants. J Pediatr Gastroenterol Nutr 2007; 44: 407–413. DOI: 10.1097/MPG.0b013e3180320643Josefsson S., Bunn S. K., Domellof M. Fecal calprotectin in very low birth weight infants. J Pediatr Gastroenterol Nutr 2007; 44: 407–413. DOI: 10.1097/MPG.0b013e3180320643Kapel N., Campeotto F., Kalach N., Baldassare M., Butel M.J., Dupont C. Faecal calprotectin in term and preterm neonates. J Pediatr Gastroenterol Nutr 2010; 51: 542–547. DOI: 10.1097/MPG.0b013e3181e2ad72Kapel N., Campeotto F., Kalach N., Baldassare M., Butel M.J., Dupont C. Faecal calprotectin in term and preterm neonates. J Pediatr Gastroenterol Nutr 2010; 51: 542–547. DOI: 10.1097/MPG.0b013e3181e2ad72Koninckx C.R., Donat E., Benninga M.A., Broekaert I.J., Gottrand F., Kolho K.L. et al. The Use of Fecal Calprotectin Testing in Paediatric Disorders: A Position Paper of the European Society for Paediatric Gastroenterology and Nutrition Gastroenterology Committee. J Pediatr Gastroenterol Nutr 2021; 72: 617–640. DOI: 10.1097/MPG.0000000000003046Koninckx C.R., Donat E., Benninga M.A., Broekaert I.J., Gottrand F., Kolho K.L. et al. The Use of Fecal Calprotectin Testing in Paediatric Disorders: A Position Paper of the European Society for Paediatric Gastroenterology and Nutrition Gastroenterology Committee. J Pediatr Gastroenterol Nutr 2021; 72: 617–640. DOI: 10.1097/MPG.0000000000003046Velasco Rodríguez-Belvís M., Viada Bris J.F., Plata Fernández C., García-Salido A., Asensio Antón J., Domínguez Ortega G. et al. Normal fecal calprotectin levels in healthy children are higher than in adults and decrease with age. Paediatrics Child Health 2019; 25: 286–292. DOI: 10.1093/pch/pxz070Velasco Rodríguez-Belvís M., Viada Bris J.F., Plata Fernández C., García-Salido A., Asensio Antón J., Domínguez Ortega G. et al. Normal fecal calprotectin levels in healthy children are higher than in adults and decrease with age. Paediatrics Child Health 2019; 25: 286–292. DOI: 10.1093/pch/pxz070

The authors declare that there are no conflicts of interest present.