Thanks...
What will be arational idea either go for one marker or to make a composite index of markers to evaluate enviornmental enteropathy?
Well, I'm not EE expert, but there are some wonderfull reviews about markers that are used for EE evaluation. Check these articles:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372657/
http://www.ajtmh.org/content/88/2/390.full.pdf+html
You can translate calprotectin in reference to clinical picture . Even polyps in colon can give raised Calprotectin . Patients who have IBD , can show raises calprotectin while having just viral infection .
Calprotectin and lactoferrin both nonspecific but fairly sensitive markers of GI inflammation in children and adults. In kids, lactoferrin > 30 and calprotectin > 50 generally considered out of range.
I should like to know what are the most frequent intestinal inflammatory disorders which may be detected by fecal calprotectin and/or lattoferrin in children under 5. My impression is that inflammatory bowel diseases are very rare events at this age.
Well, IBD are extremely rare in age under 10. But it's possible to diagnose them. The youngest patient with IBD I know, is a 3 y old boy with UC. My youngest patient was 7 y old girl with UC.
And another remark - fecal markers are quite sensitive, but very nonspecific diagnostic tool. IBD couldn't be diagnosed only using fecal markers. As Arshad Sultan said it's obligate to transfer fecal marker value to clinical condition of the patient.
Here I am not considering about any specific type of intestinal inflammatory disease, I am concerned about environmental enteropathy diagnosis criteria....
I have investigated calprotectin levels in healthy infants and children below 5 years old. The levels are higher and decline to adult levels when 4 years old. It is published i SICLI this year. In the paper the suggested cutoffs were qualified in reports from more than 150 children who had had the test performed for clinical reasons.
I hópe I am doing it the right way!
http://informahealthcare.com/doi/abs/10.3109/00365513.2013.879732
@Cheng, finally a clear answer to my question. I should like to clarify that my question was aimed to understand the usefulness of intestinal inflammation markers in children aged under 5 and clarify the range of disorders related to their alterations, since I am a gastroenterologist of adults. Useful also your answer about cut-off value which is quite similar to that of adult population.
@Nete, very interesting contribution. It could be a useful guideline. Why do you not think about a multicentric study?
In the paper in SICLI the levels of Calprotectin in different groups of disease categories are discribed. This was what we found scrutinizing patient-reports who had had the test performed. A group with mild GI disease had lower concentrations than patients with verified enteritis and the highest levels were in the IBD group.
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