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Higher fecal calprotectin levels linked to GI disease in patients with Sjögren’s syndrome
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Patients with Sjögren’s syndrome and gastrointestinal disease were more likely to have elevated levels of fecal calprotectin compared to patients without gastrointestinal disease, according to researchers from Sweden.
Researchers studied 56 patients with primary Sjögren’s syndrome (pSS) and 29 hospital workers without rheumatic or inflammatory gastrointestinal (GI) diseases. Patients with pSS had a mean age of 62 years and 54 of 56 patients were women. Control participants had a mean age of 56 years and 26 of 29 participants were women.
Patients with pSS were assessed using the EULAR Sjögren’s Syndrome Disease Activity Index. Investigators collected data including smoking status and the use of NSAIDs or proton pump inhibitors (PPIs). They studied medical records to identify concomitant diseases and to verify the presence of a chronic GI disease based on radiographic or endoscopic evidence collected within 1 year prior to the collection of stool samples. Researchers also examined serologic tests for evidence of celiac disease in the patients during the previous 8 years. All participants completed the Rome III questionnaire and a VAS for irritable bowel syndrome.
Analysis revealed significantly higher levels of fecal calprotectin in patients with pSS compared to control participants (median 54 mcg/g vs. 20 mcg/g, respectively). Pathological levels of calprotectin (50 mcg/g or higher) were observed in 52% of patients with pSS compared to 20% of control participants. Investigators found 21% of patients with pSS had levels of 150 mcg/g or greater, and no control participants had levels of fecal calprotectin at or above 150 mcg/g.
Fourteen patients with pSS had a concomitant GI disease, including one patient with lymphoma in the GI tract. Patients with GI diseases were more likely to have significantly elevated fecal calprotectin levels, and 75% of patients with fecal calprotectin at or above 150 mcg/g had GI disease. Patients with pSS had slightly higher levels of fecal calprotectin compared with healthy participants after investigators removed patients with GI disease from the analysis. A diagnosis of mucosa-associated lymphoid tissue lymphoma in the ventricle was made for one patient 18 months following the study.
Although investigators found no associations between the use of NSAIDs or PPIs with fecal calprotectin levels, disease activity and markers of inflammation slightly correlated with elevated fecal calprotectin levels. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.
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