Evaluation of fecal calgranulin c versus fecal calprotectin as noninvasive marker in predicting activity and severity of ulcerative colitis compared with colonoscopy

Background: Colonoscopy is the gold standard for ulcerative colitis diagnosis. However, colonoscopy is invasive & often requires deep sedation & extensive preparation. The current study compared fecal calgranulin C versus fecal calprotectin in ulcerative colitis as a predictor of activity, compared to the invasive procedure of colonoscopy. Patient and Methods: 50 patients diagnosed with UC were involved in this study. They enrolled from the Gastroenterology Department. Patients with gastric malignancy, necrotizing enterocolitis, IBS & colonic cancer, or pregnant females were excluded. Results: Patients in the active group had significant anemia, higher WBCs, higher absolute neutrophilic count, lower lymphocytes %, lower serum albumin levels, higher CRP levels & higher ESR levels compared to those in the remission state. Patients in the active group had higher fecal calprotectin levels (630.18 μg/mg) & fecal Calgranulin C (689.32 μg/mg) levels in comparison to patients in the remission state (76.64 & 82.68 μg/mg), respectively. While there were statistically significant negative correlations between fecal calprotectin level & hemoglobin, lymphocytes %, monocytes % & serum albumin. There were statistically significant positive correlations between fecal Calgranulin C level & WBCs, absolute neutrophilic count, neutrophils %, NLR, CRP & ESR1. There was a highly statistically significant positive correlation between fecal Calgranulin C level & fecal calprotectin levels. Conclusion: Fecal Calgranulin C is more specific compared to other inflammatory markers in the prediction of Ulcerative colitis activity. Therefore, it is recommended to include it in the follow-up of UC patients.