What is the Calprotectin test? Meaning of Calprotectin test indicators

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Article by Doctor Le Duy Cuong - Laboratory of Laboratory - Vinmec Times City International General Hospital.

Calprotectin quantification is one of the tools for fast, effective diagnosis and treatment monitoring for gastrointestinal diseases such as colitis, irritable bowel syndrome, digestive disorders...

1. What is Calprotectin?

Calprotectin is a protein complex made of calcium and zinc bound to proteins, capable of inhibiting the growth of bacteria. It accounts for more than 60% of the total protein in the cytoplasm of neutrophils, infiltrating the intestinal mucosa as part of the inflammatory response. Therefore, gastrointestinal diseases often cause increased fecal Calprotectin. Calprotectin concentrations in the stool reflect the number of leukocytes present and provide valuable information about gastrointestinal inflammation. Calprotectin quantification is one of the quick, effective diagnostic and therapeutic monitoring tools for gastrointestinal diseases such as colitis.

2. When is Calprotectin indicated?

Patients have symptoms of gastrointestinal inflammation, digestive disorders such as change in bowel habits, change in bowel frequency, change in stool pattern and characteristics of stool such as solid, liquid, constipation, pale abdominal pain perform... Differential diagnosis of colitis and irritable bowel syndrome.

Inflammatory bowel disease (IBD) is a chronic inflammatory condition that includes ulcerative colitis and Crohn's disease. Symptoms include chronic or recurrent abdominal pain and diarrhea. The clinical presentation of IBD is nonspecific and the symptoms are similar to those of other diseases such as irritable bowel syndrome (IBS), which requires endoscopy to confirm the diagnosis. The noninvasive method of fecal Calprotectin quantification is considered as a useful tool for screening and differentiating IBD and IBS, helping to reduce the indication for colonoscopy.

3. How unusual are these indicators? When to worry?

In patients with irritable bowel syndrome, calprotectin < 50 μg/g stool. However, hematologic conditions that cause agranulocytosis, leading to a false reduction in fecal Calprotectin, should be excluded.
Calprotectin 50-150 μg/g stool: it is necessary to rule out other inflammatory factors such as: gastritis caused by the use of non-steroidal anti-inflammatory drugs (NSAIDs), gastrointestinal cancer, diverticulitis...After Therefore, fecal calprotectin should be re-evaluated, if the result is < 50 μg/g stool, the patient may have only irritable bowel syndrome. If the results are still 50-150 μg/g, a colonoscopy should be indicated to find the cause.
Calprotectin > 150 μg/g stool: Physical disease, need colonoscopy to confirm diagnosis

Patients with colitis usually have 2 stages of the disease: active (inflammation) and inactive (no or slight increase in fecal calprotectin levels). These stages must be considered when interpreting the results of the Calprotectin test. Other gastrointestinal diseases, including many gastrointestinal infections and colon cancer, can cause elevated Calprotectin levels. Therefore, the diagnosis of colitis must be made with a combination of different types of tests and the clinical status of the patient.

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References:
CALPROTECTIN MEASUREMENT PROCEDURE- Vinmec Times City International Hospital INSTRUCTIONS FOR USE LIAISON Calprotectin