• Yu Bin Kim, Ju Young Kim, Sujin Choi, Hyun Jin Kim, Yoo Min Lee, Yoon Lee, Hyo-Jeong Jang, Eun Hye Lee, Kyung Jae Lee, Soon Chul Kim, So Yoon Choi, Yunkoo Kang, Dae Yong Yi, You Jin Choi, Byung-Ho Choe, and Ben Kang.
• Department of Pediatrics, Ajou University Medical Center, Suwon, Korea.
• J. Korean Med. Sci. 2022 Mar 7; 37 (9): e72.

BackgroundColorectal polyps are the most common cause of isolated hematochezia in children, which requires a colonoscopy for diagnosis. We aimed to investigate the potential utility of fecal calprotectin (FC) in assessing colorectal polyps detected by colonoscopy among children presenting with isolated hematochezia.MethodsPediatric patients of the age of < 18 years who had undergone both colonoscopy and FC tests for isolated hematochezia from June 2016 to May 2020 were included in the present multicenter, retrospective, cross-sectional study. Comparative analysis was conducted between major causes of isolated hematochezia and FC cut-offs for discriminating colorectal polyps were explored.ResultsA total 127 patients were included. Thirty-five patients (27.6%) had colorectal polyps, followed by anal fissure (14.2%), ulcerative colitis (UC; 12.6%), and others. A significant difference in FC levels was observed between patients with colorectal polyps (median, 278.7 mg/kg), anal fissures (median, 42.2 mg/kg), and UC (median, 981 mg/kg) (P < 0.001). According to receiver operating characteristic curve analysis, among patients diagnosed with colorectal polyp or anal fissure, the most accurate FC cut-off for discriminating colorectal polyps from anal fissures on colonoscopy was 225 mg/kg (sensitivity, 59.4%; specificity, 94.4%; positive predictive value [PPV], 95.0%; negative predictive value [NPV], 56.7%; area under the curve [AUC], 0.8; 95% confidence interval [CI], 0.678-0.923; P < 0.001), while among patients diagnosed with colorectal polyp or UC, the most accurate FC cut-off for discriminating colorectal polyps from UC on colonoscopy was 879 mg/kg (sensitivity, 81.2%; specificity, 56.2%; PPV, 78.8%; NPV, 60.0%; AUC, 0.687; 95% CI, 0.521-0.852; P < 0.001).ConclusionFC may assist in assessing the cause of lower gastrointestinal tract bleeding in children who present with isolated hematochezia.© 2022 The Korean Academy of Medical Sciences.

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