Positive FCal not likely to indicate IBD in peds primary care

(HealthDay)—For children with gastrointestinal symptoms seen in primary care, a positive fecal calprotectin (FCal) result is not likely to indicate inflammatory bowel disease (IBD), according to a study published in the September/October issue of Annals of Family Medicine.

Gea A. Holtman, from the University Medical Center Groningen in the Netherlands, and colleagues examined the diagnostic accuracy of FCal for IBD in symptomatic children in primary care. Two cohorts of children with chronic diarrhea, recurrent abdominal pain, or both were studied (children initially seen in primary care and children referred to specialist care). FCal was measured at baseline and compared with one of two reference standards for IBD (endoscopic assessment or one-year follow-up).

The researchers found that none of the children in the primary care cohort received an IBD diagnosis. In the primary care cohort, the specificity of FCal was 0.87. Nineteen percent of the 90 children in the referred cohort received a diagnosis of IBD; the sensitivity of FCal was 0.99 in the referred cohort.

"The findings of this study suggest that a positive FCal result in children with chronic gastrointestinal symptoms seen in primary care is not likely to be indicative of IBD," the authors write. "A negative FCal result is likely to be a true negative, which safely rules out IBD in children in whom a primary care physician considers referral to specialist care."

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