![]() After one year on a gluten-free diet, calprotectin levels in these patients returned to levels found in healthy controls. In these patients calprotectin levels correlated with the severity of histopathologic findings at diagnosis. A study of 29 children newly diagnosed with celiac disease (in its classic presentation including failure to thrive) found significantly elevated fecal calprotectin levels in patients relative to matched controls. It is not yet clear whether calprotectin might be useful in the diagnosis or management of celiac disease. A positive fecal calprotectin test should be evaluated in the context of the patient’s clinical presentation, and likely will warrant further testing. Calprotectin levels therefore may be elevated in a variety of inflammatory conditions including certain cases of celiac disease, food allergy, infectious diarrhea, diverticulitis, NSAID-induced enteropathy, and some gastrointestinal malignancies. 5įecal calprotectin is not specific for IBD but rather indicates inflammatory cell shedding into the gut lumen. 4 Overall, fecal calprotectin strongly outperforms serum C-reactive protein (CRP) and other inflammatory markers in assessing IBD treatment efficacy and in predicting disease relapse. 1 Levels of fecal calprotectin also correlate well with radio-labeled leukocyte scanning, a costly and invasive procedure formerly used to assess active intestinal inflammation in Crohn’s disease. Fecal calprotectin values have been shown to correlate with endoscopic and histological assessment of disease activity in IBD patients. Fecal calprotectin can aid in this detection, as well as provide a noninvasive means to track disease activity, risk of relapse, and response to treatment. Because levels of inflammation reflect severity of the disease process, detection and monitoring are key to clinical management. IBD, which includes Crohn’s disease and ulcerative colitis, is marked by chronic, recurrent episodes of inflammation in the gastrointestinal tract. 3 Assessing fecal calprotectin first can help clinicians identify patients with abdominal symptoms who are likely to benefit from more invasive diagnostic procedures. As a diagnostic test overall, fecal calprotectin shows a 95% sensitivity and 91% specificity for identifying IBD patients. 2 Meta-analysis of multiple similar studies involving nearly 6000 patients demonstrates even greater test sensitivity and specificity. In a study of 600 patients referred to a gastroenterology clinic with symptoms suggestive of either IBS or inflammatory intestinal disease, the sensitivity and specificity of calprotectin for predicting inflammatory disease were 89% and 79%, respectively. In most patients presenting with common intestinal symptoms, a normal fecal calprotectin can help clinicians rule out active IBD without the need for colonoscopy. Because IBS is a functional disorder, the absence of biomarkers of intestinal inflammation such as fecal calprotectin can point toward an IBS diagnosis. Many patients in the IBS category are still routinely investigated with extensive and invasive imaging studies to rule out IBD. 1Ī key problem in gastroenterology is the clinical differentiation of IBD and irritable bowel syndrome (IBS). Elevated concentrations of fecal calprotectin have been found in patients with infectious and inflammatory conditions, including IBD. ![]() Calprotectin is an abundant neutrophil protein, and its presence in stool is indicative of neutrophilic infiltration into the gut lumen associated with inflammation. Such damage may be associated with a variety of causes, including acute or chronic intestinal infection (viral, bacterial or parasitic), IBD, diverticulitis, celiac disease, food allergy, NSAID-induced enteropathy, and colorectal cancer.ĭiagnosTechs has offered stool markers of intestinal inflammation for some time, and we also now offer a test for fecal calprotectin. ![]() Elevated stool inflammatory biomarkers point to an active process of intestinal mucosal cell damage. Laboratory stool analysis is the most convenient and noninvasive means of assessing inflammation in the intestinal tract. ![]() It also is indicated for complaints such as fever, weight loss, and fatigue, which are often associated with inflammatory bowel disease (IBD) or other inflammatory intestinal disorders.īecause intestinal inflammation is not directly observable by patients or clinicians, laboratory assays provide critical information to help determine the presence, location, and magnitude of such inflammation. By DiagnosTechs ChronoBiology 16 October 8, 2013Īssessing the presence, severity, and extent of intestinal inflammation is an essential component in the workup of patients with common digestive complaints such as abdominal pain and cramping, bowel movement disturbances, bloating, and flatulence. ![]()
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