High Within-day Variability of Fecal Calprotectin Levels in Patients with Active Ulcerative Colitis

Abstract

FC values widely vary between motions in patients with active UC. Stool sample collection from the first bowel movement in the morning does not ensure the highest or lowest within-day FC value. In patients with overt active UC, a single FC determination should not be used as the basis for therapeutic strategies.

Association Between Fecal Calprotectin Levels and Small-bowel Inflammation Score in Capsule Endoscopy: A Multicenter Retrospective Study

“…Moreover, the correlation was moderate for FC, and if this biomarker was used to guide the decision to perform CE, at least 40 % of patients will be misdiagnosed. However, the use of single FC measurement per patient for the purpose of this study [36,37], its retrospective nature and the use of different laboratories and FC kits should be considered as additional limitations of this study. Nevertheless, FC C 76 lg/g may be associated with appreciable inflammation on CE in patients with negative prior diagnostic workup.…”

Fecal calprotectin in inflammatory bowel diseases: update and perspectives

“…Some efforts have now to be made to ensure commutability of results. Moreover, two recent studies have evidenced a high intra-individual variability, up to 40%, suggesting that a single determination of calprotectin may be insufficient to monitor relapse risk or treatment [36,70]. This high variability may be partly due to the variability of the extraction process since the relative quantity of water in stools may vary across the day.…”

Luminally expressed gastrointestinal biomarkers

“…Furthermore, there has been some emerging evidence that FC levels may display intra-individual variability from day to day, or even within the same day, observed in individuals with active IBD [32], [33], quiescent IBD [34] and also normal individuals [35].…”

“…Therefore it is suggested that more attention needs to be paid to timing of sample collection and the practicalities of sample storage [32], and also that multiple or serial FC measurements [33] are obtained. Optimal cut-offs may also differ by disease (UC, CD), brand of assay used, distribution of inflammation, and age of patient [36].…”