PWE-026 7-Alpha-Cholestenone and Faecal Calprotectin in Patients with Collagenous Colitis
Authors: R Trimble, D Yung, A Koulaouzidis
Journal: Gut (2016)

<h3>Introduction</h3> Collagenous colitis (CC) causes chronic, watery diarrhoea.<sup>1</sup> Bile acid malabsorption (BAM) often accompanies CC<sup>2,3</sup> and CC can respond to treatment with BA sequestrants.<sup>4</sup> The European Microscopic Colitis Group (EMCG) advises that BAM should be sought in investigation for CC.<sup>1</sup> The selenium-labelled homocholic acid-taurine (SeHCAT) test is considered the gold standard for BAM diagnosis; however, serum 7 alpha-hydroxy-4-cholesten-3-one (7 aC) is simpler and less expensive, with comparable sensitivity.<sup>5</sup> Faecal calprotectin (FC) is well-established as a biomarker of bowel inflammation, but data in CC is scant.<sup>6</sup> We present data from a tertiary referral centre on 7 aC and FC in patients with CC. <h3>Methods</h3> Pathology records were interrogated for patients diagnosed with CC (2000–2015), extracting results on 7 aC and FC. Results are presented as mean (±SD) or median (range). <h3>Results</h3> Over 15 years, 399 patients were diagnosed with CC (280 F/119 M). Of these, 164 were excluded from further analysis due to lack of appropriate data. 7 aC was available in 83 (20.8%) patients, mean levels of 11.5 ± 9.70 ng/ml. 11/83 (13.3%) patients had elevated 7 aC . FC levels were measured in 101 (25.3%) patients, mean levels 251.89 ± 282.62 µg/g. Of these, 76/101 (75.2%) had elevated FC ≥ 50 µg/g (FC ≥ 100 µg/g: 63/101; FC ≥ 200 µg/g: 30/101). Of the 101 patients with FC measurement, 76 had FC results ± 30 days from the point of histological diagnosis. In this group, median FC was 165 µg/g, range 20–1375 µg/g. <h3>Conclusion</h3> This is the first cohort data on 7 aC in CC. Our findings confirm that a significant proportion of CC patients have co-existing BAM; however, the incidence is lower than that reported in other studies using SeHCAT. The high incidence of raised FC in our cohort supports the position that FC is a useful marker of histologic inflammation in CC. <h3>References</h3> 1 Münch A, <i>et al</i>. Microscopic colitis: current status, present and future challenges: statements of the European Microscopic Colitis Group. <i>J Crohns Colitis</i>. <b>201</b>;6:932–45. 2 Wildt S, <i>et al</i>. Bile Acid Malabsorption in Patients with Chronic Diarrhoea: Clinical Value of SeHCAT Test. <i>Scand J Gastroenterol</i> 2003;<b>38</b>:826–30. 3 Fernández-Bañares F, <i>et al</i>. Bile acid malabsorption in microscopic colitis and in previously unexplained functional chronic diarrhea. <i>Dig Dis Sci</i> 2001;<b>46</b>:2231–8. 4 Münch A, Langner C. Microscopic colitis: clinical and pathologic perspectives. <i>Clin Gastroenterol Hepatol</i> 2015;<b>13</b>:228–36. 5 Brydon W G, <i>et al</i>. An evaluation of the use of serum 7-alpha-hydroxycholestenone as a diagnostic test of bile acid malabsorption causing watery diarrhea. <i>Can J Gastroenterol</i> 2011;<b>25</b>:319–23. 6 Wildt S, <i>et al</i>. Metabolic and inflammatory faecal markers in collagenous colitis. <i>Eur J Gastroenterol Hepatol</i> 2007;<b>19</b>:567–74. <h3>Disclosure of Interest</h3> None Declared