Niet-invasieve markers bij inflammatoire darmziekten op de kinderleeftijd

Non-invasive markers of inflammation in blood or stool samples may be of help in children suspected of inflammatory bowel disease (ibd). Positive results will support the need for more invasive investigations, while some markers are of value in determining the type of ibd, as well as disease activity. Anemia and thrombocytosis are general indicators of ibd. Elevated erythrocyte sedimentation rate is often found in active Crohn's disease. In ibd colitis, asca and p-anca can be used in order to categorise the disease as either Crohn's disease or ulcerative colitis. The presence of these antibodies seems to be related to age of presentation, localisation of disease, results of treatment and outcome. Fecal alpha-1-antitrypsin is mainly increased in Crohn's disease, but is not clearly related to disease activity. Determination of fecal calprotectin in ibd seems to be more reliable, though in adults fecal calprotectin levels may be increased in colorectal carcinoma and nsaid-induced enteropathy. Fecal lactoferrin does not discriminate between Crohn's disease and ulcerative colitis, but is related to disease activity.