Fecal calprotectin

A biochemical measurement of the protein calprotectin in the stool.

Elevated stool levels indicates the migration of neutrophils to the intestinal mucosa, which occurs during intestinal inflammation, including inflammation caused by inflammatory bowel disease.

A stool test that is used to detect inflammation in the intestines.

It provides a quantitative measure of inflammation.

Intestinal inflammation is associated with, for example, some bacterial infections and, in people with inflammatory bowel disease (IBD), it is associated with disease activity and severity.

It is not diagnostic but may be used to distinguish between IBD and non-inflammatory disorders and to monitor the severity of IBD.

The test may eliminate the need for invasive colonoscopy or radio-labelled white cell scanning.

Fecal Calprotectin is useful for diagnosing Crohn’s disease among patients in whom both inflammatory bowel disease and irritable bowel syndrome are being considered.

Fecal calprotectin is the most sensitive screening test for IBD with the specificity of 0.67%.

A 24 kDa dimer of calcium binding proteins S100A8 and S100A9.

The complex accounts for up to 60% of the soluble protein content of the neutrophil cytosol.

Has bacteriostatic and fungistatic properties, that arise from its ability to sequester manganese and zinc.

Can be easily measured in feces.

Reference ranges:

2-9 years 166 microg/g of feces

10-59 years 51

> 60 years 112

The main diseases that cause an increased excretion of fecal calprotectin are inflammatory bowel diseases, celiac disease, infectious colitis, necrotizing enterocolitis, intestinal cystic fibrosis and colorectal cancer.

Regularly used as indicator for inflammatory bowel diseases (IBD) during treatment and as diagnostic marker.

Inflammatory processes result in an influx of neutrophils into the bowel lumen.

Calprotectin comprises as much as 60% of the soluble protein content of the cytosol of neutrophils, it can serve as a marker for the level of intestinal inflammation.

Measurement strongly correlated with 111-indium-labelled leucocytes, the gold standard measurement of intestinal inflammation.

Levels of fecal calprotectin are normal in patients with irritable bowel syndrome (IBS).

Low levels indicate mild inflammation or normal endoscopy, and high levels correlate with ulceration.

It is a non-invasive, qualitative biomarker that can predict colitis risk.

In untreated celiac disease, concentration levels of fecal calprotectin correlate with the degree of intestinal mucosal lesion.

Fecal calprotectin levels normalize with a gluten-free diet.

Fecal is measured using immunochemical techniques such as ELISA or immunochromatographic assays.

Fecal levels can be associated false-positive if the laboratory uses low calprotectin cut-off levels.

Intake of non-steroidal anti-inflammatory drugs increases calprotectin values, possibly due to the associated induced enteropathy.

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