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Epic Code LAB1230580 Calprotectin, Feces

Important Note

Issue additional container for specimen collection if collecting multiple stool tests. Do not combine with other containers.

Interface Order Alias

1230580

Clinical Information

Fecal calprotectin is a non-invasive biomarker for distinguishing inflammatory bowel disease (IBD), such Crohn’s disease (CD) or ulcerative colitis (UC), from irritable bowel syndrome (IBS) when used in conjunction with other diagnostic modalities, including endoscopy, histology, and imaging.

 

Fecal calprotectin is a calcium-and zinc-binding protein comprising 60% of the total cytoplasmic protein content of neutrophils.  In the process of inflammation, neutrophils are activated, leading to release of cellular proteins, including calprotectin.  Calprotectin translocates across the epithelial barrier, enters the lumen of the gut, and is absorbed by the fecal material.  The amount of calprotectin present in the feces is proportional to the number of neutrophils within the gastrointestinal mucosa.

 

When used for the differential diagnosis of IBD from IBS, fecal calprotectin has a sensitivity of 80% and specificity of 88% at the cut-off of 160 mcg/g.  However, it must be remembered that increases in fecal calprotectin are not diagnostic for IBD, as other disorders such as celiac disease, colorectal cancer, and gastrointestinal infections, may also be associated with neutrophilic inflammation.

Icons & Photos

or
Stool Collection Kit - Please use the "Empty Vial"  Sterile Collection Container with Screw on Lid

 

 

Collection Instructions

Specimen Type: Stool


Container/Tube: Sterile Empty vial (white cap) of the stool specimen collection kit or sterile collection container with screw-on lid.

Minimum volume: 1 gram or 1 mL

Collection Instructions: 

  • Issue additional container for specimen collection if collecting multiple stool tests. Do not combine with other containers.
  • Be sure the cap is secured.
  • Fresh unpreserved stool is required.
  • See resources for patient collection sheet

Specimen Transport Temperature (off-site collection): Refrigerated is preferred but Ambient is acceptable

Lab Staff Instructions

LOOK+LOOK

  • Sample can be received ambient or on a cold pack, do not reject ambient specimens without consulting a toxicology tech first.
  • Once the specimen is received in SHRL Lab Central, store the specimen in the refrigerator for pick up by the Toxicology Lab. 

Rejection Criteria

Specimens will be rejected if

  • Stool collection is greater than 72 hours once received in the laboratory
  • Sample is collected in vial containing a preservative/fixative
  • Leaky specimen - Make sure all container lids are fastened evenly and securely.
  • Frozen specimens are unacceptable

Specimen Stability

Ambient: 3 days

Refrigerated: 6 days

Frozen: Unacceptable

Laboratory Retention: 3 days

Test Frequency

Test performed Monday, Wednesday, Friday, with average TAT 1 - 3 days

Reference Range

<80 mcg/g (Normal)

80-160 mcg/g (Borderline)

>160 mcg/g (Abnormal)

Reference values established for ≥ 4 years old.

 

Interpretation

Fecal calprotectin concentrations <80 mcg/g are not indicative of active inflammation in the gastrointestinal tract with a negative predictive value of approximately 91%. 

 

Fecal calprotectin concentrations between 80 and 160 mcg/g are borderline and may not be directly indicative of an active inflammation.  Re-evaluation of fecal calprotectin levels after 4 to 6 weeks is recommended.

 

Fecal calprotectin concentrations >160 mcg/g are indicative of an active inflammatory process with a positive predictive value of approximately 86%.  Further diagnostic testing to determine the etiology of the inflammation is suggested.

 

Limitations/Cautions

 

Falsely increased fCAL concentrations can be caused by the following:

  • Proton pump inhibitors.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Enteropathological microorganisms
    • Ova and parasites
    • Bacteria

 

Falsely decreased fCAL concentrations can be caused by the following:

  • Patients who have granulocytopenia due to bone marrow depression.

Performing Department

TOXICOLOGY

Performing Department Laboratory Location

Spectrum Health Regional Laboratory (SHRL, Grand Rapids)

Methodology

Turbidimetric

CPT

83993

CDM Code

80106036

Epic Test ID

1230102198

LOINC

38445-3

Beaker LOINC

FECAL CALPROTECTIN: 38445-3

Mayo Access Code

SHO1230580

Reviewed Date

12/18/2020

Beaker Names

Beaker Procedure Name: FECAL CALPROTECTIN
Beaker Display Name: Fecal Calprotectin
BEAKER TEST NAME: Fecal Calprotectin
BEAKER TEST REPORT NAME: Fecal Calprotectin

Beaker Synonyms

No synonym on file

Beaker Collection and Specimen Handling

BEAKER COLLECTION: LOOK + LOOK

Beaker Location, Container and Temperature

BW TOXICOLOGY: STERILE CONTAINER A (Preferred)-Ambient