Type of test Stool

Normal findings

≤ 50 mcg/g

Borderline: 50.1-120 mcg/g ,  Abnormal: ≥ 120.1 mcg/g

Test explanation and related physiology

 Calprotectin comprises a majority of soluble protein content in the cytosol of neutrophils. Elevated fecal calprotectin indicates the migration of neutrophils to the intestinal mucosa that occurs during inflammation. This test is used to identify patients with inflammation of the intestines (e.g., celiac disease) and particularly inflammatory bowel diseases (e.g., Crohn’s disease and ulcerative colitis).

The test is helpful as an ancillary diagnostic test for inflammatory bowel diseases and is a biomarker for treatment assessment. It is normal in patients with irritable bowel disease. The level of calprotectin in stool correlates significantly with endoscopic colonic inflammation in both ulcerative colitis and Crohn disease and fecal lactoferrin. Colorectal neoplasia and gastrointestinal (GI) infection also increase fecal calprotectin.

 Interfering factors

* Drugs that can increase levels include aspirin and nonsteroidal antiinflammatory medications.

Procedure and patient care

 Before

* Explain the procedure to the patient.

* Tell the patient that no fasting is needed.

During

• Collect a fresh random stool specimen. No preservatives are needed.

• The specimen must be frozen within 18 hours of collection.

• Collect separate specimens when multiple tests are ordered.

 Do not add to previously collected specimens.

• Note that specimens cannot be collected from a diaper .

Abnormal findings

Increased levels

- Crohn disease

- Ulcerative colitis

- Celiac disease

- Infectious colitis

- Necrotizing enterocolitis

- Antineutrophil cytoplasmic antibody