Fecal calprotectin as a measure of disease activity in childhood inflammatory bowel disease

J Pediatr Gastroenterol Nutr. 2001 Feb;32(2):171-7. doi: 10.1097/00005176-200102000-00015.


Background: Calprotectin is an abundant neutrophil protein that is extremely stable in feces. The aim of this study was to assess the effectiveness of fecal calprotectin as a noninvasive measure of disease activity in childhood inflammatory bowel disease (IBD) by comparison to a modified Lloyd-Still and Green score and laboratory inflammatory indices.

Methods: Spot fecal samples from 37 children with IBD and 31 control children were sent by ordinary mail to the laboratory. Fecal calprotectin concentration was measured by an in-house enzyme linked immunosorbent assay (ELISA). A modified Lloyd-Still & Green score (mLSS) was calculated for each child with IBD within 10 days of obtaining the fecal sample.

Results: Compared with control values (median, range) (2.1, 0.5-6.3 mg/L), fecal calprotectin was increased in 16 children with ulcerative colitis, (11.5, 0.6-272.5 mg/L, P < 0.001) and in 21 children with Crohn disease, (14.0, 0.7-59.7 mg/L, P < 0.001). Twelve "moderately affected" children (mLSS of 35-65) had higher fecal calprotectin concentrations (22.2, 2.7-141.7 mg/L) than 25 "mildly affected" children (mLSS > 65), (10.3, 0.6-272.5 mg/L, P = 0.002). For the total IBD group, fecal calprotectin concentration correlated negatively with the mLSS (r = -0.61, P < 0.001). It also correlated negatively with serum albumin concentration (r = -0.49, P = 0.002) and positively with erythrocyte sedimentation rate (r = 0.40, P = 0.01).

Conclusions: Fecal calprotectin seems to reflect bowel inflammation in children with IBD. As a simple, safe, noninvasive test, it has the potential to reduce the number of invasive investigations performed in these children.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Biomarkers / analysis
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Enzyme-Linked Immunosorbent Assay
  • Feces / chemistry*
  • Female
  • Humans
  • Infant
  • Inflammatory Bowel Diseases / diagnosis
  • Inflammatory Bowel Diseases / metabolism*
  • Leukocyte L1 Antigen Complex
  • Male
  • Membrane Glycoproteins / analysis*
  • Membrane Glycoproteins / isolation & purification
  • Membrane Glycoproteins / metabolism
  • Neural Cell Adhesion Molecules / analysis*
  • Neural Cell Adhesion Molecules / isolation & purification
  • Neural Cell Adhesion Molecules / metabolism
  • Severity of Illness Index


  • Biomarkers
  • Leukocyte L1 Antigen Complex
  • Membrane Glycoproteins
  • Neural Cell Adhesion Molecules