Background: In spite of being invasive and expensive, endoscopic and histologic evaluation measures remain the
gold standard for diagnosis of ulcerative colitis. There is a need for widely available, reasonably priced biomarkers
for testing outside of endoscopic evaluation. Objective: To evaluate fecal calgranulin C, Neutrophil / Lymphocyte
ratio and Lymphocyte / Monocyte ratio in ulcerative colitis patients as noninvasive biomarkers of disease activity and
severity compared with colonoscopy.
Patients and Methods: A cross - sectional study was conducted on 50 patients with ulcerative colitis and were
classified into two groups: Group I: (50) patients in active state and Group II: the same (50) patients in remission
state. Patients were subjected to thorough clinical examination, laboratory investigations including fecal calgranulin
C and colonoscopic assessment.
Results: Fecal calgranulin C, neutrophils, monocytes and N/LR were reliable indicators of activity and severity of
active UC compared to inactive UC (p < 0.001). The mean fecal calgranulin C level for UC in exacerbation and
remission was (709.30 ± 172.31 and 84.86 ± 19.42) pg/ml respectively. The optimal cutoff was estimated at
185pg/ml with sensitivity and a specificity of 94% and 92%, respectively. Significant elevation of NLR was observed
in active UC group compared to inactive UC (2.44 ± 0.56 and 1.56 ± 0.36) respectively.
Conclusion Fecal calgranulin C and NLR could be used as noninvasive markers to predict activity and severity of
UC and to reduce the need for invasive endoscopies