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We have investigated gastrointestinal inflammation in SSc at the time of diagnosis using the inflammatory biomarker Fecal calprotectin (F-cal). Consecutive patients with suspected SSc were characterized in relation to the 2013 classification criteria for SSc and classified as SSc or SSc-like disease. F-cal levels were measured with a polyclonal ELISA (Calpro A\/S, Lysaker, Norway) and levels above 50\u00a0\u00b5g\/g were considered elevated. F-cal levels were compared to those of control subjects without rheumatic disease. Of 137 patients with suspected SSc, 92 were classified as SSc and 45 as SSc-like disease. Median (interquartile range) disease duration among the SSc participants was 2.5 (1.2, 4.6) years. A substantial proportion of participants classified as SSc (35\/92, 38%) and SSc-like disease (14\/45, 31%) exhibited elevated F-cal compared to the control group (3\/41, 7.3%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 and <jats:italic>p<\/jats:italic>\u2009=\u20090.007, respectively). Elevated F-cal was associated with proton pump inhibitor usage (OR 7.14; 95% CI 2.56\u201329.93; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). We conclude that elevated F-cal is present in a subgroup of patients with SSc at the time of diagnosis, suggesting that that GI inflammation may be present in this patient group early in the disease course. F-cal did not exhibit potential to differentiate SSc from SSc-like disease.<\/jats:p>","DOI":"10.1007\/s00296-022-05264-4","type":"journal-article","created":{"date-parts":[[2022,12,25]],"date-time":"2022-12-25T13:02:38Z","timestamp":1671973358000},"page":"961-967","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Elevated fecal levels of the inflammatory biomarker calprotectin in early systemic sclerosis"],"prefix":"10.1007","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9678-5348","authenticated-orcid":false,"given":"Viggo","family":"Hamberg","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4915-2924","authenticated-orcid":false,"given":"Johan K.","family":"Wallman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5706-203X","authenticated-orcid":false,"given":"Elisabeth","family":"Mogard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9937-6352","authenticated-orcid":false,"given":"Elisabet","family":"Lindqvist","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9919-4487","authenticated-orcid":false,"given":"Tor","family":"Olofsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7021-2541","authenticated-orcid":false,"given":"Kristofer","family":"Andr\u00e9asson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,12,25]]},"reference":[{"issue":"10103","key":"5264_CR1","doi-asserted-by":"publisher","first-page":"1685","DOI":"10.1016\/s0140-6736(17)30933-9","volume":"390","author":"CP Denton","year":"2017","unstructured":"Denton CP, Khanna D (2017) Systemic sclerosis. 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JKW: consultant of AbbVie, Amgen, Celgene, Eli Lilly, Novartis (unrelated to the current study). EM: consultant of Novartis (unrelated to the current study). EL: none. To has performed consulting tasks for Merck Sharp and Dohme and for Eli Lilly (unrelated to the current study). KA: none.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}