FECAL LACTOFERRIN AS A DIFFERENTIATION MARKER BETWEEN ULCERATIVE COLITIS AND IRRITABLE BOWEL SYNDROME
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This study was designed to estimate fecal lactoferrin (LF) concentration and to evaluate its clinical applicability as non-invasive modality for differentiation between cases with ulcerative colitis (UC) and irritable bowel syndrome (IBS) and its relation to disease activity. The study included 15 patients with UC and15 patients with IBS and 15 healthy volunteers as controls. All patients were evaluated clinically for disease activity and underwent colonoscopy for diagnosis assurance. The study participants supplied fresh fecal samples for qualitative and quantitative assay for LF. There were 11 patients with active UC and 6 patients with active IBS. There was a significant (P<0.05) increase of fecal LF in patients with UC (1118.21277.8 μg/gm feces) compared to controls (1.35 10.48 μg/ gm feces) and IBS patients (1.33 10.36 μg/ gm feces). Moreover, there was a significant (P<0.05) increase of fecal LF in patients with active UC compared to those with inactive UC, whereas non-significantly (P>0.05) different in patients with active IBS compared to those inactive IBS. Furthermore, there was a significant correlation between fecal LF level and score of severity of inflammation in patients with UC (r=0.623, P=0.013), whereas the correlation was nonsignificant in patients with IBS, (r=0.225, P>0.05). Qualitative determination of LF could identify patients with UC with sensitivity of 93.3%, specificity and positive predictive value of 100% and accuracy of diagnosis by 97.8% irrespective of the severity of the disease. It could be concluded that qualitative determination of fecal LF could differentiate between patients with UC and IBS with specificity 100% and accuracy 97.8% and quantitative estimation of its level could define cases with active UC.