ArticleUnited European gastroenterology journal2025
Clinical relevance of calprotectin in patients with perianal fistulas in Crohn's disease and cryptoglandular fistulas.
Article in United European gastroenterology journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Biomarkers in the pathogenesis and diagnosis of Crohn's perianal fistulas: a systematic review.Techniques in coloproctology · 2026Pooled it
- Does fistula calprotectin tell us which treatment to choose?Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026Article
- Multiomics analysis dissects the molecular foundation of perianal fistulas associated with Crohn's disease and of cryptoglandular origin.Journal of Crohn's & colitis · 2026Article
- Differentiating perianal fistulizing Crohn's disease from cryptoglandular fistulae: Moving towards early and accurate diagnosis.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Article
- Metabolic profiles of amino acids in patients with crohn's disease-associated perianal fistulas and cryptoglandular anal fistulas.Scientific reports · 2026Article
- Article
- Clinical relevance of calprotectin in patients with perianal fistulas in Crohn's disease and cryptoglandular fistulas.United European gastroenterology journal · 2025Article
- The Role of Calprotectin in the Diagnosis and Treatment of Inflammatory Bowel Disease.International journal of molecular sciences · 2025Review
- Differential Diagnosis Value of Neutrophil Gelatinase Associated Lipocalin as a Noninvasive Biomarker in Perianal Fistulizing Crohn's Disease.Journal of inflammation research · 2025Article
- Management and Treatment of Perianal Fistulizing Crohn's Disease.Clinical and experimental gastroenterology · 2025Review
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7 authors.
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Abstract
BACKGROUND AND
aimsPrevious literature suggests that faecal calprotectin (FC) discriminates Crohn's disease perianal fistulas from cryptoglandular fistulas, irrespective of luminal disease. This study aims to prospectively validate this and analyse if increased local fistula calprotectin levels are associated with fistula characteristics.
methodsIn this prospective study, all consecutive patients with an active perianal fistula undergoing examination under anaesthesia were included. Faecal and fistula tract scraping calprotectin levels were determined. The primary objective was to analyse whether FC levels could be used to differentiate between Crohn's disease and cryptoglandular perianal fistulas. Secondary outcome parameters were the levels of local calprotectin in fistula scrapings and their correlation with fistula characteristics.
resultsSixty-three patients were included in this study (perianal Crohn's disease; 45, cryptoglandular; 18). Faecal calprotectin levels were significantly higher in Crohn's disease patients compared with cryptoglandular fistula (354.3 [58.8-1076.3] vs. 47.3 [14.6-233.6] μg/g, p = 0.003). Faecal calprotectin could accurately discriminate Crohn's disease patients with active luminal disease from patients without luminal disease (median [interquartile range]) (1167.0 [557.0-2806.3] vs. 93.0 [47.5-571.6] μg/g, p = 0.001). Faecal calprotectin was not related to calprotectin levels in fistula scrapings. No fistula characteristic was found to be correlated to scraping calprotectin, but a correlation was found with the TOpCLASS classification system, which stratifies fistulas according to disease severity and outcome: class 2a (amenable for repair), class 2b (symptom control) and class 2c (gradually debilitating disease): 140[31.0-149.0]) μg/g versus 706[198.5-1936] μg/g versus 4000[1337-5894] μg/g, p < 0.001). Scraping calprotectin was also related to pronounced hyperintensity of the fistula tract on MRI in Crohn's disease patients: (69.0[30.0-821.0] vs. 1284.0[204.3-4185.5]; p = 0.01)) and cryptoglandular patients: (30.0[13.5-80.5] vs. 3012.0 [923.8-5021.0]; p = 0.002).
conclusionCrohn's disease and cryptoglandular perianal fistulas differ in FC levels. Local fistula calprotectin production did not explain this difference, implying FC reflects the luminal condition. A correlation exists between scraping calprotectin levels and Crohn's disease fistula severity, which could be clinically relevant for prognostic cohorts and tailored treatment.
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