Intestinal Research

Original Articles

IBD

Usefulness of fecal immunochemical test and fecal calprotectin for detection of active ulcerative colitis: Dong Ju Kim, Yoon Mi Jeoun, Dong-won Lee, Ja Seol Koo, Sang Woo Lee; Intest Res 2018;16(4):563-570. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00020

Background/Aims
Ulcerative colitis undergoes periods of exacerbation and remission. Fecal calprotectin levels increase with gut inflammation and correlate with endoscopic disease activity in ulcerative colitis. Intestinal blood loss and fecal immunochemical test levels also correlate with endoscopic disease activity. This study statistically evaluated the usefulness of fecal calprotectin, fecal immunochemical test, and C-reactive protein (CRP) as markers of disease activity.
Methods
A total 106 ulcerative colitis patients who underwent endoscopy and fecal calprotectin, fecal immunochemical test, and CRP testing, from March 2015 to August 2016, were retrospectively reviewed. Disease activity was assessed using a partial Mayo score and Mayo endoscopic score. The ability of fecal and serologic tests to reflect endoscopic disease severity was statistically evaluated.
Results
Among 106 patients, 68 underwent endoscopy and stool study within 2 weeks. In patients with mild to severe activity, fecal immunochemical test and fecal calprotectin were superior to CRP at Mayo endoscopic score detection rate. The area under the curves of fecal immunochemical test and fecal calprotectin for the detection of Mayo endoscopic score ≥1 were 0.956 and 0.942, respectively, and were superior to that of CRP (0.756). At Mayo endoscopic score, the effects of combination of fecal immunochemical test and CRP or fecal calprotectin and CRP were found to be higher than those of the independent fecal immunochemical test or fecal calprotectin.
Conclusions
Fecal immunochemical test and fecal calprotectin can effectively detect active ulcerative colitis better than remission. As these markers reflect the status of mucosal inflammation, they may reduce the requirement for invasive endoscopic examination.

Citations

Citations to this article as recorded by

Histologic features and predicting prognosis in ulcerative colitis patients with mild endoscopic activity
Seung Yong Shin, Hee Sung Kim, Kisung Kim, Chang Won Choi, Jung Min Moon, Jeong Wook Kim, Hyun Jin Joo, Jeongkuk Seo, Muhyeon Sung, Chang Hwan Choi
The Korean Journal of Internal Medicine.2024; 39(1): 68. CrossRef
Prostaglandin E‐major urinary metabolite diagnoses mucosal healing in patients with ulcerative colitis in remission phase
Toshiyuki Sakurai, Yoshihiro Akita, Haruna Miyashita, Ryosuke Miyazaki, Yuki Maruyama, Tomoko Saito, Mariko Shimada, Takuji Yamasaki, Seiji Arhihiro, Tomohiro Kato, Tomokazu Matsuura, Masahiro Ikegami, Isao Okayasu, Masayuki Saruta
Journal of Gastroenterology and Hepatology.2022; 37(5): 847. CrossRef
Alternative diagnoses and demographics associated with a raised quantitative faecal immunochemical test in symptomatic patients
Mark S Johnstone, Gillian Miller, Grace Pang, Paul Burton, Georgios Kourounis, Jack Winter, Emilia Crighton, David Mansouri, Paul Witherspoon, Karen Smith, Stephen T McSorley
Annals of Clinical Biochemistry: International Journal of Laboratory Medicine.2022; 59(4): 277. CrossRef
Correlation of fecal calprotectin and patient-reported outcome measures in patients with ulcerative colitis
Nagesh Kamat, Sudheer K Vuyyuru, Saurabh Kedia, Pabitra Sahu, Bhaskar Kante, Peeyush Kumar, Mukesh Kumar Ranjan, Mukesh Kumar Singh, Sambuddha Kumar, Vikas Sachdev, Govind Makharia, Vineet Ahuja
Intestinal Research.2022; 20(2): 269. CrossRef
Determining the usefulness of Capsule Scoring of Ulcerative Colitis in predicting relapse of inactive ulcerative colitis
Mao Matsubayashi, Taku Kobayashi, Shinji Okabayashi, Masaru Nakano, Shintaro Sagami, Ryo Ozaki, Hiroki Kiyohara, Hiromu Morikubo, Kunio Asonuma, Yusuke Miyatani, Shin Maeda, Toshifumi Hibi
Journal of Gastroenterology and Hepatology.2021; 36(4): 943. CrossRef
Biomarkers of Inflammation in Inflammatory Bowel Disease: How Long before Abandoning Single-Marker Approaches?
Gabriele Dragoni, Tommaso Innocenti, Andrea Galli
Digestive Diseases.2021; 39(3): 190. CrossRef
Biomarkers Predictive of Response to Thiopurine Therapy in Inflammatory Bowel Disease
Jack S. Cornish, Elisa Wirthgen, Jan Däbritz
Frontiers in Medicine.2020;[Epub] CrossRef
Predictive values of stool-based tests for mucosal healing among Taiwanese patients with ulcerative colitis: a retrospective cohort analysis
Hsu-Heng Yen, Mei-Wen Chen, Yu-Yao Chang, Hsuan-Yuan Huang, Tsui-Chun Hsu, Yang-Yuan Chen
PeerJ.2020; 8: e9537. CrossRef
What is the appropriate cut-off value of CRP to predict endoscopic remission in patients with ulcerative colitis in clinical remission?
Jongbeom Shin, Sung Min Kong, Gyeol Seong, Young-Ho Kim
International Journal of Colorectal Disease.2020; 35(12): 2249. CrossRef
Prostaglandin E-Major Urinary Metabolite Predicts Relapse in Patients With Ulcerative Colitis in Clinical Remission
Natsuki Ishida, Kiichi Sugiura, Takahiro Miyazu, Satoshi Tamura, Satoshi Suzuki, Shinya Tani, Mihoko Yamade, Moriya Iwaizumi, Yasushi Hamaya, Satoshi Osawa, Takahisa Furuta, Ken Sugimoto
Clinical and Translational Gastroenterology.2020; 11(12): e00289. CrossRef
Approaches to Integrating Biomarkers Into Clinical Trials and Care Pathways as Targets for the Treatment of Inflammatory Bowel Diseases
Parambir S. Dulai, Laurent Peyrin-Biroulet, Silvio Danese, Bruce E. Sands, Axel Dignass, Dan Turner, Gerassimos Mantzaris, Juergen Schölmerich, Jean-Yves Mary, Walter Reinisch, William J. Sandborn
Gastroenterology.2019; 157(4): 1032. CrossRef

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Clinical features of active tuberculosis that developed during anti-tumor necrosis factor therapy in patients with inflammatory bowel disease: Jang Wook Lee, Chang Hwan Choi, Ji Hoon Park, Jeong Wook Kim, Sang Bum Kang, Ja Seol Koo, Young-Ho Kim, You Sun Kim, Young Eun Joo, Sae Kyung Chang; Intest Res 2016;14(2):146-151. Published online April 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.2.146

Abstract PDF PubReader ePub

Background/Aims

Anti-tumor necrosis factor (TNF) therapy for active ulcerative colitis (UC) and Crohn's disease (CD) is associated with increased risks of tuberculosis (TB) infection. We analyzed the incidence and clinical features of Korean patients with inflammatory bowel disease (IBD) who developed active TB during anti-TNF therapy.

Methods

Ten cases of active TB developed in patients treated with infliximab (n=592) or adalimumab (n=229) for UC (n=160) or CD (n=661) were reviewed. We analyzed demographics, interval between start of anti-TNF therapy and active TB development, tests for latent TB infection (LTBI), concomitant medications, and the details of diagnosis and treatments for TB.

Results

The incidence of active TB was 1.2% (10/821): 1.5% (9/592) and 0.4% (1/229) in patients receiving infliximab and adalimumab, respectively. The median time to the development of active TB after initiation of anti-TNF therapy was three months (range: 2–36). Three patients had past histories of treatment for TB. Positive findings in a TB skin test (TST) and/or interferon gamma releasing assay (IGRA) were observed in three patients, and two of them received anti-TB prophylaxis. Two patients were negative by both TST and IGRA. The most common site of active TB was the lungs, and the active TB was cured in all patients.

Conclusions

Active TB can develop during anti-TNF therapy in IBD patients without LTBI, and even in those with histories of TB treatment or LTBI prophylaxis. Physicians should be aware of the potential for TB development during anti-TNF therapy, especially in countries with a high prevalence of TB.

Citations

Citations to this article as recorded by

(Re-)introduction of TNF antagonists and JAK inhibitors in patients with previous tuberculosis: a systematic review
Thomas Theo Brehm, Maja Reimann, Niklas Köhler, Christoph Lange
Clinical Microbiology and Infection.2024; 30(8): 989. CrossRef
Real-world effectiveness of ustekinumab in maintenance therapy for Crohn´s disease
O.V. Knyazev, O.B. Schukina, A.V. Kagramanova, A.A. Lishchinskaya, I.A. Li, E.A. Sabelnikova, B.A. Nanaeva, M.Yu. Timanovskaya, T.A. Kosacheva, N.A. Fadeeva, K.A. Nikolskaya, E.Yu. Zhulina, N.V. Kamzarakova, A.I. Parfenov
Dokazatel'naya gastroenterologiya.2023; 12(3): 29. CrossRef
Five-Year Efficacy and Safety of Ustekinumab Treatment in Crohn’s Disease: The IM-UNITI Trial
William J. Sandborn, Rory Rebuck, Yuhua Wang, Bin Zou, Omoniyi J. Adedokun, Christopher Gasink, Bruce E. Sands, Stephen B. Hanauer, Stephan Targan, Subrata Ghosh, Willem J.S. de Villiers, Jean-Frederic Colombel, Brian G. Feagan, John P. Lynch
Clinical Gastroenterology and Hepatology.2022; 20(3): 578. CrossRef
Monitoring frequency of interferon gamma release assay for tuberculosis surveillance following infliximab therapy in patients with Crohn's disease
Qin Yu Yang, Yi Juan Liu, Ye Xu, Lin Zhang, Cheng Dang Wang
Journal of Digestive Diseases.2021; 22(8): 473. CrossRef
Clinical Features and Outcomes of Tuberculosis in Inflammatory Bowel Disease Patients Treated with Anti-tumor Necrosis Factor Therapy
Jihye Kim, Jong Pil Im, Jae-Joon Yim, Chang Kyun Lee, Dong Il Park, Chang Soo Eun, Sung-Ae Jung, Jeong Eun Shin, Kang-Moon Lee, Jae Hee Cheon
The Korean Journal of Gastroenterology.2020; 75(1): 29. CrossRef
Increased Risk of Herpes Zoster in Young and Metabolically Healthy Patients with Inflammatory Bowel Disease: A Nationwide Population-Based Study
Hosim Soh, Jaeyoung Chun, Kyungdo Han, Seona Park, Gukhwan Choi, Jihye Kim, Jooyoung Lee, Jong Pil Im, Joo Sung Kim
Gut and Liver.2019; 13(3): 333. CrossRef
Discontinuation of Biological Treatments in Inflammatory Bowel Disease
Shomron Ben-Horin, Ren Mao, Yun Qiu, Minhu Chen
Journal of Clinical Gastroenterology.2018; 52(1): 6. CrossRef
Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 2: management
Dong Il Park, Tadakazu Hisamatsu, Minhu Chen, Siew Chien Ng, Choon Jin Ooi, Shu Chen Wei, Rupa Banerjee, Ida Normiha Hilmi, Yoon Tae Jeen, Dong Soo Han, Hyo Jong Kim, Zhihua Ran, Kaichun Wu, Jiaming Qian, Pin-Jin Hu, Katsuyoshi Matsuoka, Akira Andoh, Yasu
Intestinal Research.2018; 16(1): 17. CrossRef
Novel treatments for inflammatory bowel disease
Hyo Sun Lee, Soo-Kyung Park, Dong Il Park
The Korean Journal of Internal Medicine.2018; 33(1): 20. CrossRef
Nonimmunity against hepatitis B virus infection in patients newly diagnosed with inflammatory bowel disease
Seong Jae Yeo, Hyun Seok Lee, Byung Ik Jang, Eun Soo Kim, Seong Woo Jeon, Sung Kook Kim, Kyeong Ok Kim, Yoo Jin Lee, Hyun Jik Lee, Kyung Sik Park, Yun Jin Jung, Eun Young Kim, Chang Heon Yang
Intestinal Research.2018; 16(3): 400. CrossRef
Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti‐tumor necrosis factor treatment. Part 2: Management
Dong Il Park, Tadakazu Hisamatsu, Minhu Chen, Siew Chien Ng, Choon Jin Ooi, Shu Chen Wei, Rupa Banerjee, Ida Normiha Hilmi, Yoon Tae Jeen, Dong Soo Han, Hyo Jong Kim, Zhihua Ran, Kaichun Wu, Jiaming Qian, Pin‐Jin Hu, Katsuyoshi Matsuoka, Akira Andoh, Yasu
Journal of Gastroenterology and Hepatology.2018; 33(1): 30. CrossRef
Changing treatment paradigms for the management of inflammatory bowel disease
Jong Pil Im, Byong Duk Ye, You Sun Kim, Joo Sung Kim
The Korean Journal of Internal Medicine.2018; 33(1): 28. CrossRef
Incidence of Active Tuberculosis within One Year after Tumor Necrosis Factor Inhibitor Treatment according to Latent Tuberculosis Infection Status in Patients with Inflammatory Bowel Disease
Jieun Kang, Dae Hyun Jeong, Minkyu Han, Suk-Kyun Yang, Jeong-Sik Byeon, Byong Duk Ye, Sang Hyoung Park, Sung Wook Hwang, Tae Sun Shim, Kyung-Wook Jo
Journal of Korean Medical Science.2018;[Epub] CrossRef
CD8 + CD28 + /CD8 + CD28 − T cell equilibrium can predict the active stage for patients with inflammatory bowel disease
Shi-xue Dai, Hong-xiang Gu, Qian-yi Lin, Shao-zhuo Huang, Tiao-si Xing, Qing-fang Zhang, Gang Wu, Min-hua Chen, Wan-er Tan, Hong-jian Jian, Zhong-wen Zheng, Tao Zhong, Min-hai Zhang, Xing-fang Cheng, Peng Huang, Guang-jie Liao, Wei-hong Sha
Clinics and Research in Hepatology and Gastroenterology.2017; 41(6): 693. CrossRef

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Gastric lesions in patients with Crohn's disease in Korea: a multicenter study: Hoonsub So, Byong Duk Ye, Young Soo Park, Jihun Kim, Joo Sung Kim, Won Moon, Kang-Moon Lee, You Sun Kim, Bora Keum, Seong-Eun Kim, Kyeong Ok Kim, Eun Soo Kim, Chang Kyun Lee, Sung Pil Hong, Jong Pil Im, Ja Seol Koo, Chang Hwan Choi, Jeong Eun Shin, Bo In Lee, Kyu Chan Huh, Young-Ho Kim, Hyun-Soo Kim, Young Sook Park, Dong Soo Han; Intest Res 2016;14(1):60-68. Published online January 26, 2016; DOI: https://doi.org/10.5217/ir.2016.14.1.60

Abstract PDF PubReader ePub

Background/Aims

Gastric pathology and Helicobacter pylori (H. pylori) infection among Asian patients with Crohn's disease (CD) are still unclear. We evaluated gastric histologic features and frequency of H. pylori infection in Korean patients with CD.

Methods

Among 492 patients with CD receiving upper gastrointestinal (GI) endoscopic evaluation in 19 Korean hospitals, we evaluated the endoscopic findings and gastric histopathologic features of 47 patients for our study. Histopathologic classification was performed using gastric biopsy tissues, and H. pylori infection was determined using the rapid urease test and histology.

Results

There were 36 men (76.6%), and the median age of patients at the time of upper GI endoscopy was 23.8 years (range, 14.2–60.5). For CD phenotype, ileocolonic disease was observed in 38 patients (80.9%), and non-stricturing, non-penetrating disease in 31 patients (66.0%). Twenty-eight patients (59.6%) complained of upper GI symptoms. Erosive gastritis was the most common gross gastric feature (66.0%). Histopathologically, H. pylori-negative chronic active gastritis (38.3%) was the most frequent finding. H. pylori testing was positive in 11 patients (23.4%), and gastric noncaseating granulomata were detected in 4 patients (8.5%). Gastric noncaseating granuloma showed a statistically significant association with perianal abscess/fistula (P=0.0496).

Conclusions

H. pylori-negative chronic active gastritis appears to be frequent among Korean patients with CD. The frequency of H. pylori infection was comparable with previous studies. An association with perianal complications suggests a prognostic value for gastric noncaseating granuloma in patients with CD.

Citations

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Endoscopic findings in the upper gastrointestinal tract in patients with Crohn’s disease are common, highly specific, and associated with chronic gastritis
Katarzyna Graca-Pakulska, Wojciech Błogowski, Iwona Zawada, Anna Deskur, Krzysztof Dąbkowski, Elżbieta Urasińska, Teresa Starzyńska
Scientific Reports.2023;[Epub] CrossRef
Detection Rates of Non-Cavitary Epithelioid Cell Granuloma by Gastrointestinal Biopsy in Patients with Treatment-Naïve Crohn’s Disease
Katsuya Endo, Yoko Kawakami, Yuki Yoshino, Shiho Kondo, Daisuke Fukushi, Atsuko Takasu, Takayuki Kogure, Morihisa Hirota, Kazuhiro Murakami, Kennichi Satoh
Inflammatory Intestinal Diseases.2023; 8(3): 105. CrossRef
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Endoscopic and Histopathological Findings of the Esophagus, Stomach, and Duodenum in Patients with Crohn’s Disease from a Reference Center in Bahia, Brazil
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Gastrointestinal Disorders.2020; 2(2): 164. CrossRef
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Case Reports in Gastrointestinal Medicine.2020; 2020: 1. CrossRef
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Andréa Maia Pimentel, Raquel Rocha, Genoile Oliveira Santana
World Journal of Gastrointestinal Pharmacology and Therapeutics.2019; 10(2): 35. CrossRef
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Benjamin Rothschild, Firas Rinawi, Yonatan Herman, Osnat Nir, Raanan Shamir, Amit Assa
Scandinavian Journal of Gastroenterology.2017; 52(6-7): 716. CrossRef
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Kwang Il Seo, Won Moon
The Korean Journal of Gastroenterology.2017; 69(2): 151. CrossRef
Characteristics of Upper Gastrointestinal Tract Involvement in Korean Pediatric Crohn's Disease: A Multicenter Study
Ji Hyoung Park, Hye Na Nam, Ji-Hyuk Lee, Jeana Hong, Dae Yong Yi, Eell Ryoo, In Sang Jeon, Hann Tchah
Pediatric Gastroenterology, Hepatology & Nutrition.2017; 20(4): 227. CrossRef
Increased duodenal expression of miR-146a and -155 in pediatric Crohn’s disease
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World Journal of Gastroenterology.2016; 22(26): 6027. CrossRef

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Case Report

Two Cases of Cecal Schwannoma Which Were Removed by Endoscopic Mucosal Resection: Byeong Kwang Choi, Rok Seon Choung, Sang Yup Lee, Tae Un Yang, Sun Hwa Kim, In Kyung Yoo, Sang Kyu Lee, Seung Young Kim, Sung Woo Jung, Ja Seol Koo, Jong Jin Hyun, Hyung Joon Yim, Sang Woo Lee, Jai Hyun Choi; Intest Res 2013;11(1):56-59. Published online January 31, 2013; DOI: https://doi.org/10.5217/ir.2013.11.1.56

Abstract PDF

Schwannoma in colorectum is a rare subepithelial polyp of mesenchymal origin, which is derived from the neural sheath, and most of reported cases were removed surgically. We, herein, describe two cases of schwannoma of the cecum, which were removed by endoscopic mucosal resection. A 34-year-old man and a 62-year-old man presented with abdominal discomfort and bowel habit change. The patients were diagnosed with a subepithelial tumor in the cecum on colonoscopy and underwent endoscopic mucosal resection under a tentative impression as neuroendocrine tumor, such as carcinoid tumor. Histopathology and immunohistochemistry confirmed the colonic lesion to be a benign schwannoma. (Intest Res 2013;11:56-59)

Citations

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Solitary schwannoma of the ascending colon
Myeong Su Chu, Hyun Mo Kang, Hyeong Ju Sun, Dong Min Kim, Hyong Jong Kwak
Yeungnam University Journal of Medicine.2016; 33(1): 37. CrossRef

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