AB0633 FECAL CALPROTECTIN IN PATIENTS WITH SYSTEMIC SCLEROSIS

Background: Systemic sclerosis (SSc) is a connective tissue disease with heterogeneous symptoms and a non-predictable process. The most involved organ after the skin is the gastrointestinal tract (GI tract) and any part of it can be affected. The calprotectin level is increased in plasma, urine, sputum and feces when an inflammatory process is occurring with the presence of neutrophils which is measurable. Objectives: So we decided to examine fecal calprotectin as a simple method to diagnose GI disorders and disease activity in SSc. Methods: Totally 46 patients with SSc were invited by telephone, who have been referred to sayyad shirazi Hospital and the rheumatologists’ offices in Gorgan and their information has been registered there. Seven patients did not enter our study because of having the items in exclusion criteria like Diabetes, a history of GI operation and having other connective tissue diseases at the same time.for the other 39 patients who was remained, a questionnaire about GI symptoms (UCLA SCTS 2.0) was filled in and then their skin was examined and the skin score was determined (the score more than 14 was considered as positive). Blood sample was taken from all patients to do tests as ESR,CRP, Magnesium, albumin, Ferritin, Folic acid, Vitamin B12 and Zinc and use them as a scale for malnutrition. Then the stool samples were collected to measure the calprotectin level. At last to determine GI disorders in a non-aggressive way, Barium Swallow (Esophagus malfunction) and CT Enterography (intestinal disorders) was done. The patients in our study according to the median of age which was 42, was divided in to two groups: young and middle aged. Due to the fact that FC level wasn’t less than 50µgr/gr in any of our cases, the patients was divided in to two groups: the one with FC level less than 200 µgr/gr and the one with FC level as 200 µgr/gr or more than 200 µgr/gr and the latter was considered as positive. Results: As we didn’t have any male patients, the correlation between FC level and sex was not verifiable. Increased levels of FC didn’t have any correlation with age (P Value=0.79), disease type (P Value=0.59), small intestine wall thickening (P Value=0.10), esophageal dilatation (P Value=0.18), skin score (P Value=0.25), final GI score (P Value=0.30) and none of serum tests. One of the most important reasons, was low sample size.In our study just 5 cases had evidence of wall thickening in CT Enterography and all that 5 cases had increased levels of calprotectin so we see that if we have a lrager sample size we may ensure the connection between these two variables. Also as most of our patients take vitamin and mineral supplements, we couldn’t find any signs of micronutrient deficiencies and any correlation with FC level as well. Conclusion: Although there was no statistical correlation between FC level and variables, the results are in favor of FC’s specificity for assessing intestinal wall thickening. References [1] -Marie I, Leroi aM, Menard JF, Levesque H, Quillard M, Ducrotte P. Fecal calprotectin in systemic sclerosis and review of the literature. Autoimmunity reviews. 2015;14(6):547-54. [2] - andreasson K, Scheja a, Saxne T, Ohlsson B, Hesselstrand R. Faecal calprotectin: a biomarker of gastrointestinal disease in systemic sclerosis. J intern Med. 2011;270(1):50-7. [3] - affandi aJ, Radstake TR, Marut W. Update on biomarkers in systemic sclerosis: tools for diagnosis and treatment. Seminars in immunopathology. 2015;37(5):475-87. Disclosure of interests: None declared