GI Function Test: Faecal Calprotectin

Purpose of the test

Calprotectin is a stable protein that accounts for about 60% of neutrophil cytosolic protein. Calprotectin is released into the faeces when neutrophils gather at the site of any G.I tract inflammation. Calprotectin can provide a non-invasive, inexpensive and objective method for assessing patients for additional possible invasive procedures e.g.Colonscopy or imaging studies. The faecal calprotectin test has a relatively high specificity and sensitivity (approximately 90%) for distinguishing between non-inflammatory bowel disorders (e.g. irritable bowel syndrome) and inflammatory bowel disease (e.g. ulcerative colitis and Crohn's disease). Calprotectin will also be elevated in some cases of GI tract malignancy (e.g. colorectal cancer). Calprotectin is regularly raised in active IBD. Faecal calprotectin concentrations relate well to disease activity in the inflammatory bowel diseases and can therefore be used to monitor therapy. There is good correlation between faecal calprotectin concentration and ¹¹¹Indium white cell labelling techniques. Calprotectin is a very stable protein and stool samples can be sent by post for analysis. The test is non-invasive and can be used on adults and children; the same reference range appears to apply to both.

Reference Range

<60 µg/g faeces - this is not applicable to neonatal samples.

Sample Requirements

Random faecal sample (any time of day, no dietary restrictions required) in a plain universal container and approximately 1 gram in weight.

NOTE: Samples grossly contaminated with blood are unsuitable for FCALP analysis.

Storage and Transport

First class post within 4 days (temperature not to exceed 30°C during transport)

Turnaround Time

5-7 working days

Price

Price available on application - please contact adrianturner1@nhs.net. Discounts could be available for significant workloads.

Contacts

Ms Audrey Duffy

T 020 3299 4133

E audreyduffy@nhs.net

Dr Joanne Marsden

T 020 - 3299 3856

E joannemarsden1@nhs.net

References

Takeuchi K, Smale S, Premchand P, Maiden L, Sherwood R, Thjodleifsson B, Bjornsson E, Bjarnason I. (2006) Prevalence and mechanism of non-steroidal anti-inflammatory drug-induced clinical relapse in patients with anti-inflammatory bowel disease Clin Gastroenterol & Hepatol4: 196-202

Thjodleifsson B, Sigthorsson G, Cariglia N, Reynisdottir I, Gdbjartsson DF, Kristjansson K, Meddings JB, Gudnason V, Wandall JH, Andersen LP, Sherwood RA, Kjeld M, Oddsson E, Gudjonsson H, Bjarnason I (2003) Subclinical intestinal inflammation: an inherited abnormality in Crohn's disease relatives? Gastroenterology 124: 1728-37

Tibble J, Sigthorsson G, Foster R, Sherwood R, Fagerhol M, Bjarnason I (2001) Faecal calprotectin and faecal occult blood tests in the diagnosis of colorectal carcinoma and adenoma. Gut 49: 402-9

Tibble J, Teahon K, Thjodleifsson B, Roseth A, Sigthorsson G, Bridger S, Foster R, Sherwood R, Fagerhol M, Bjarnason I (2000) A simple method for assessing intestinal inflammation in crohn's disease. Gut 47: 506-13

5-HIAA