Fecal Calprotectin as Screening Parameter for Hepatic Encephalopathy

Background: Hepatic encephalopathy is a big neuropsychiatric problem that can happen with cirrhosis. It slowly happens in people with cirrhosis, starting with changes in their sleep patterns and moving on to asterixis, stupor, and coma. Aim: To evaluate the role of fecal calprotectin is a good screening parameter of hepatic encephalopathy in patients with cirrhosis of the liver. Patients and methods: This comparative cross-sectional research has been conducted on 80 subjects divided into both groups Group I (N=60): Cases with cirrhosis suffering hepatic encephalopathy and Group II (N=20): Healthy subjects as controls matched with study group in sex and age who were admitted at Department of Hepatology, Gastroenterology and Infectious Diseases, Damanhur Teaching Hospital. Results: With AUC of 0.929, Fecal Calprotectin can significantly predict the incidence of hepatic encephalopathy (P44.6 μg/mg, with range 16.7-640, with 78.57% sensitivity, 92.11% specificity 91.7% PPV and 79.5% NPV. With AUC of 0.966, Serum ammonia can significantly predict the incidence of hepatic encephalopathy (P72.5 mcg/dL, with 90.00% sensitivity, 100.00% specificity, 100.0% PPV and 76.9% NPV. There was an insignificant relation between grades of encephalopathy and fecal calprotectin level, as fecal calprotectin level was insignificant different among the grades of encephalopathy. Conclusion: Fecal calprotectin, especially at higher cutoff values, shows potential as a predictive biomarker for hepatic encephalopathy, providing a non-invasive method for early detection and risk evaluation in individuals with cirrhosis.