Avaliação da calprotectina fecal como biomarcador para o diagnóstico de inflamação intestinal em pacientes com espondiloartrite

• Ano de defesa: 2019
• Autor(a) principal: Júlia Faria Campos
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; Brasil; HCL - HOSPITAL DAS CLINICAS; Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto; UFMG
• Palavras-chave em Português: calprotectina fecal; biomarcador; espondiloartrite; espondilite anquilosante; doença inflamatória intestinal; Espondiloartrite Axial; Espondilite Anquilosante; Biomarcadores; Doenças Inflamatórias Intestinais; Dissertação Acadêmica
• Link de acesso: http://hdl.handle.net/1843/60319

Introduction: Microscopic bowel inflammation is present in up to 60% of patients with spondyloarthritis (SpA) and it may be associated with more severe articular disease and higher risk of developing inflammatory bowel disease (IBD). It was conducted a study to determine the values of fecal calprotectin (fCAL) that are related to microscopic and endoscopic bowel inflammation in patients with SpA, treated or not with non-steroidal anti-inflammatory drugs (NSAIDS). Materials and Methods: FCAL measurement and ileocolonoscopy with multiple biopsies were performed in 65 patients with SpA (44 AS,14 PsA, 7 NR axSpA) to assess the presence of microscopic and endoscopy signs of bowel inflammation. Results: In 47 (72,3%) the levels of fCAL were higher than 50 µg/g and 20 (30,7%) showed results above 250 µg/g. A total of 40 (60,6%) patients with SpA presented with microscopic bowel inflammation and 13 (19,7%) presented with erosions, enantema and/or ulcer at the ileocolonoscopy. FCAL levels were significantly higher in patients who presented with microscopic bowel inflammation compared to those without inflammatory findings in the ileoconolonoscopy biopsies (p < 0.001), and were marginally higher in patients with inflammatory signs (enantema, erosions and ulcers) found at the ileocolonoscopy (p= 0,053). A cutoff of 96 µg/g of fCAL was able to predict microscopic bowel inflammation with 73% sensitivity and 67% specificity. There was no significative difference in fCAL levels between patients treated or not with NSAIDS. Conclusions: The evaluation of fCAL levels proved to be useful in the identification of microscopic bowel inflammation in patients with SpA, treated or not with NSAIDS. It may be of utility in the stratification of those with higher risk of presenting with microscopic inflammation and could help in the more judicious indication of ileocolonoscopy. A fCAL cutoff value of 96 µg/g predicted microscopic bowel inflammation with 73% sensitivity and 67% specificity. These result support the use of fCAL for the evaluation of microscopic bowel inflammation in SpA patients.