Lab Guide
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Test ID: Calprotectin
Calprotectin
Calprotectin
Useful For

The measurement of stool calprotectin is useful for the differentiation of inflammatory bowel disease (IBD) from other similarly presenting disorders such as irritable bowel syndrome.

In diagnosed IBD patients, calprotectin can be monitored to aid assessment of treatment response.

Method name and description

A latex turbidimetric assay is used for the measurement of stool calprotectin.

 

Clinical information

Calprotectin is a calcium-binding protein produced by neutrophils.  In inflammatory bowel disease (IBD), such as ulcerative colitis and Crohn disease, neutrophils accumulate in the gut and calprotectin is released and excreted into the stool.

The measurement of stool calprotectin can aid in the differentiation of IBD and other similarly presenting disorders such as irritable bowel syndrome.  This then guides subsequent patient management and therapy.

Aliases

Fecal calprotectin

Stool calprotectin

Specimen type / Specimen volume / Specimen container

Specimen type: A single random stool sample.

Specimen volume: 1 – 5 g approximately one teaspoonful.

Specimen container: suitable plain clean collection container.

 

 

Collection instructions / Special Precautions / Timing of collection

Stool Sample Collection Instruction for Calprotectin:

Prepare a clean disposable container for stool collection.

Please collect the sample from the first bowel movement of the day.

Place your disposable container into the toilet bowl and pass the stool into this, try to ensure that the stool does not touch the inside of the toilet. Alternatively, lift the toilet seat and place cling film over the toilet bowl, leaving a slight dip in the center. Place the toilet seat down and pass the stool onto the cling film.

It is important that urine or water from the toilet is not collected with the stool sample.

Scoop some of the stool into the specimen container using the spatula attached to the lid. Try to avoid any areas of the stool that contain food remains or mucous.

Ideally, the specimen container should be one quarter full. If this is not possible, a large pea sized amount is the minimum needed for testing.

Screw the lid on tightly and put the specimen container into the sample bag and seal. Please make sure that the completed request form is attached to the sample bag.

Discard the rest of the stool in the toilet.

Place the disposable container and/or cling film and anything else used to collect the sample into a plastic bag, tie securely and put straight into the dustbin.

Wash your hands thoroughly.

Please take your sample to your designated laboratory as quickly as possible.

 

Storage and transport instructions

Stool samples can be transported at ambient temperature as quickly as possible.

Stool samples are stable for up to 7 days at 2 –8 °C.

Stool samples are stable for up to 6 months at -80 °C. The sample should not be thawed till analysis.

Samples should be transported according to their storage conditions.

Specimen Rejection Criteria

Sample quantity less than 1 gm.

Highly mucoid specimens.

Wrong container.

Biological reference intervals and clinical decision values

<50 µg/g stool: normal

50-200 µg/g stool: borderline raised calprotectin, which could reflect mild gastrointestinal inflammation, NSAID or aspirin use. If the patient is not known to have IBD, a repeat stool calprotectin after at least 4 weeks is recommended to aid review of this result.

>200 µg/g stool: raised calprotectin, suggestive of gastrointestinal inflammation that may be consistent with active IBD.

Calprotectin concentrations > 50 and <119 µg/g are borderline and could be following treatment, NSAID or aspirin use. A follow-up repeat can be after 4- 6 weeks.

 

Calprotectin concentrations ≥ 119 µg/g are suggestive IBD. Further workup may be needed.

Factors affecting test performance and result interpretation

Very bloody and/or mucoid samples may produce misleading results.

Turnaround time / Days and times test performed / Specimen retention time

Turnaround time: 10 working days.

Days and times test peformed: Once a week.

Specimen retention time: Until patient result is released.