The role of fecal calprotectin in assessment of hepatic encephalopathy in patients with liver cirrhosis

Introduction : Calprotectin is a cytoplasmatic protein of neutro- philic granulocytes and it is an established marker for the assess- ment of localized intestinal inflammation. Aim : To explore correlation between values of fecal calprotectin and degree of liver cirrhosis and hepatic encephalopathy. Methods : We included 60 patients with liver cirrhosis and 37 healthy patients as controls. Patients revealing other causes of ab- normal calprotectin results (gastrointestinal bleeding or inflamma- tory bowel disease) were excluded. The degree of liver insufficiency was assessed according to the Child-Pugh classification and Model of End Stage Liver Disease (MELD), and degree of hepatic enceph- alopathy by West-Haven criteria, serum concentration of ammo- nium ion and the number connection test. Results : The mean value of fecal calprotectin in patients with liver cirrhosis was 189.1 ± 168.0 µg/g, and 35.0 ± 26.0 µg/g in the control group, respectively. We have confirmed significantly higher fecal calprotectin in patients with cirrhosis (p < 0.001). There were no significant differences in values of fecal calprotectin between the patients with different stages of liver cirrhosis according to Child- Pugh classification and MELD score (p > 0.05). We observed statis- tically significant difference comparing fecal calprotectin by West- Haven criteria of hepatic encephalopathy (p < 0.001), while there were no correlation with the number connection test and serum concentration of ammonium ion (p > 0.05). Conclusion : We confirmed significantly higher values of fecal calprotectin in patients with liver cirrhosis, especially in hepatic encephalopathy according to West-Haven criteria. (Acta gastro- enterol. belg., 2014, 77, 302-305).