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Fecal calprotectin (FC) is a marker of intestinal inflammation. Data are limited on utility of routine FC testing in pediatric primary care. Participants 0 to 18 years old who had an FC test in the years 2010-2014 were retrospectively identified. Those with less than a year of follow-up or a prior diagnosis of inflammatory bowel disease (IBD) were excluded. In all, 84% (689/822) had normal FC; no participant with normal FC was diagnosed with IBD in the subsequent 12 months. Also, 16% (133/822) had elevated FC, and 31% of those (42/133) were diagnosed with IBD. FC values for IBD and non-IBD groups were 1084 μg/g (interquartile range [IQR] = 514.4-2000) and 27.05 μg/g (IQR = 15.6-62.6; P < .001), respectively. Abdominal pain was the primary indication. In this cohort, sensitivity of FC for IBD is 100%, and specificity is 88%. The FC test can be an excellent tool in the primary care setting to exclude IBD and avoid unnecessary referrals and colonoscopies. [ABSTRACT FROM AUTHOR]

The article discusses the medical cases of two patients diagnosed with progressive familial intrahepatic cholestasis type 3 (PFIC3). The first patient underwent ursodeoxycholic acid (UDCA) therapy and her liver indices remained stable over the best 4 years. UDCA therapy was also initiated on the second patient after discontinuation of chelation. Both patients have marked hepatic copper overload and liver histology consistent with Wilson disease (WD).