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PTD - 193

Test Directory -  Faecal Calprotectin

Clinical Indications

Faecal calprotectin is a neutrophil marker protein that gives an objective measure of gastrointestinal inflammation. Calprotectin is a non-specific marker of gastrointestinal disease of both inflammatory and neoplastic character and its high sensitivity and negative predictive values can be useful to select patients for colonoscopy. 
It may also be useful for early detection of relapse in IBD and
monitoring disease activity and response to treatment.

Request Form 

Combined Pathology Blood form (Yellow/Black or Blue for GP's)

Availability

Analysed on request. Routinely, no repeat within 6 months.

Specific Criteria

Investigation of IBS/IBD, monitoring known IBD patients on treatment.

Samples referred to Basildon Hospital for Faecal Calprotectin analysis from other Hospitals should be packaged in accordance with our transportation policy and will be assumed to have met the specific criteria of the referring laboratory.

Patient Preparation

The first morning faecal sample should be used. Samples should not be taken for at least 3 days following colonoscopy (if required for monitoring). NSAIDs must be stopped for at least 4 weeks prior to testing.

Limitations

 

Reference ranges are not validated for use in children under 4 years of age and results may be elevated in this population due to incomplete closure of the gut, particularly in children under 1 year of age.

Turnaround Time

7 days

Specimen

Early morning stool sample

Volume

5 grams (pea sized amount)

Container

Blue Capped Universal

Causes for Rejection

Not meeting specific criteria for analysis, unlabelled sample. Heavily blood stained or mucus like stools. 

Reference Range and Interpretation

Cut-off for exclusion of active GI inflammation is less than 60 ug/g faeces, although local audit suggests a cut-off of 109 ug/g gives better sensitivity and specificity for distinguishing IBS and IBD. It should be noted that calprotectin is not distributed homogenously and results can be variable by up to 20% on the same faecal sample.

Diverticulitis and infection (e.g. campylobacter) may cause elevated faecal calprotectin levels. NSAIDs may also cause elevation but not usually more than 200 ug/g. Results from mucus like and watery samples should be interpreted with caution as mucus strongly binds calprotectin and watery samples may not contain any actual stool.

Lab. Handling

Processing: Label with a yellow sticker, force 2 labels, and store sample at 4C in separating fridge (CB39), FCAL box. Sample is extracted within 3 days and extract is stored in separating freezer (CB40) at -20C, FCAL to be done rack.


Version 1.3 / February 2015                                                                                                    Approved by: Consultant Biochemist