In acute appendicitis, faecal calprotectin levels are markedly high

Takeaway

• In this small study, patients with acute appendicitis (AA) had higher levels of faecal calprotectin (FC) than those with similar symptoms but no AA.
• External validation in larger sample sizes needed.

Why this matters

• AA frequently presents a diagnostic challenge.
• Calprotectin is the major soluble protein in neutrophils, and FC reflects neutrophil recruitment to the bowel.
• High calprotectin levels were recently described in the lumen of appendices removed for appendicitis.

Key results

• FC levels in patients:
  • With AA (n=40) vs without (n=44): 240.5 vs 68.5 μg/g (P<.001).
  • With suppurative (n=14) vs simple AA (n=26): 304 vs 206 μg/g (P=.001).
• Area under the curve for AA detection, 0.928 (95% CI, 0.855-0.972).
• Optimal cutoff, 106 μg/g.

Study design

• Prospective single-centre study of adults presenting to an emergency department with abdominal pain and suspected AA (n=84).
• Authors measured FC, then completed diagnostic workup, and treatment (if necessary) while masked to FC result.
• Outcomes: FC performance to diagnose AA.
• Funding: Science and Education Foundation of Wujiang District (China).

Limitations

• Recruitment time frame and criteria unclear.
• Small sample size.
• Cutoffs may vary by assay.