Measurement of Serum and Fecal Calprotectin in Egyptian Ankylosing Spondylitis Patients

Abstract Background Axial spondyloarthropathies are chronic, often progressive, inflammatory disorders of the axial skeleton including the sacroiliac joints. Patients suffer from pain, fatigue, limited spinal motility, functional disability, and impaired psychological wellbeing AS has many extra-articular manifestations, it has been concluded 4-6% of patients with AS have symptomatic inflammatory bowel disease. Objective To estimate role of serum and/or faecal calprotectin in ankylosing spondylitis disease activity, especially in patients with intestinal symptoms. Methods This was a cross sectional study which was done on 40 ankylosing spondylitis patients diagnosed according to history, clinical examination and laboratory data according to ASAS classification criteria of ankylosing spondylitis 2009. Results Our study revealed that there was a positive relation between serum/ fecal calprotectin and disease activity according to ASDAS-CRP. Most of the patients with positive serum and fecal calprotectin had high disease activity with percentage of 56.2% (p-value=0.008) and 54.8% (p- value=0.026) respectively. Hemoglobin levels were lower among patients with positive serum and fecal calprotectin levels which was of statistical significance with p-value of 0.002 and 0.016 respectively. Also, hemoglobin level was affected by the Prescence of GIT symptoms being lower among patients with GIT symptoms with p-value 0.025. ESR level was higher among patients with positive serum and fecal calprotectin levels which was of statistical significance with p-value of 0.036 and 0.032 respectively. Conclusion Serum calprotectin was more sensitive and specific than fecal calprotectin as a biomarker for disease activity in Egyptian ankylosing spondylitis patients. There was a positive relation between serum/fecal calprotectin and disease activity. There was a negative relation between serum/fecal calprotectin and hemoglobin level. The most common gastrointestinal symptoms among Egyptian ankylosing spondylitis patients were abdominal pain and constipation.