The intra-individual variability of faecal calprotectin: A prospective study in patients with active ulcerative colitis

Lasson, Anders; Stotzer, Per-Ove; Öhman, Lena; Isaksson, Stefan; Sapnara, Maria; Strid, Hans

doi:10.1016/j.crohns.2014.06.002

Cited by 132 publications

(164 citation statements)

References 25 publications

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“…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.…”

Section: One or Several Thresholds: That Is The Questionmentioning

confidence: 99%

“…The collection of the stool samples could be done at home and then sent to the laboratory. However, one study has shown that the concentration of fecal calprotectin decreases from the third day after collection at room temperature [36]. Before assay, samples could be stored at 2-8 °C for 6 days.…”

Section: Technical Principle and Analytical Performances Pre-analyticsmentioning

confidence: 99%

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Fecal calprotectin in inflammatory bowel diseases: update and perspectives

Manceau

Chicha-Cattoir²,

Puy

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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Inflammatory bowel diseases (IBDs) are chronic diseases that result from the inflammation of the intestinal wall, suspected in any patient presenting with intestinal symptoms. Until recently, the diagnosis was mainly based on both clinical and endoscopic arguments. The use of an easy, fast, reliable, non-invasive, and inexpensive biological assay is mandatory not only in diagnosis but also in evolutionary and therapeutic monitoring. To date, the fecal calprotectin is the most documented in this perspective. This marker allows the discrimination between functional and organic bowel processes with good performance. The determination of the fecal calprotectin level contributes to the evaluation of the degree of disease activity and to monitoring of therapeutic response.

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Section: One or Several Thresholds: That Is The Questionmentioning

confidence: 99%

Section: Technical Principle and Analytical Performances Pre-analyticsmentioning

confidence: 99%

Fecal calprotectin in inflammatory bowel diseases: update and perspectives

Manceau

Chicha-Cattoir²,

Puy

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…FC levels decrease with increasing time between bowel movements; therefore, it is recommended that samples be obtained from the first bowel movement of the day (14). Because of the day-to-day variability in FC levels (14), retrieving samples at similar times over two consecutive days is preferable.…”

Section: Abstract: Disease Activity; Fecal Calprotectin; Inflammatormentioning

confidence: 99%

Clinicians’ Guide to the Use of Fecal Calprotectin to Identify and Monitor Disease Activity in Inflammatory Bowel Disease

Bressler

Panaccione

Fedorak

et al. 2015

Canadian Journal of Gastroenterology and Hepatology

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BACKGROUND: Objective monitoring of the severity of inflammation in patients with inflammatory bowel disease (IBD) is an essential part of disease management. However, repeat endoscopy to define extent and severity of inflammation is not practical. Fecal calprotectin (FC) is a biomarker that can be used as a surrogate test to distinguish inflammatory from noninflammatory gastrointestinal disease.METHODS: A targeted search of the literature regarding FC, focusing primarily on the past three years, was conducted to develop practical clinical guidance on the current utility of FC in the routine management of IBD patients.RESULTS: It is recommended that samples for FC testing be obtained from the first bowel excretion of the day. FC testing should be used as standard of care to accurately confirm inflammation and ‘real-time’ disease activity when a clinician suspects an IBD flare. Although FC is a reliable marker of inflammation, its role in routine monitoring in improving long-term outcomes has not yet been fully assessed. Based on available evidence, the authors suggest the following cut-off values and management strategies: when FC levels are <50 μg/g to 100 μg/g, quiescent disease is likely and therapy should be continued; when FC levels are >100 μg/g to 250 μg/g, inflammation is possible and further testing (eg, colonoscopy) is required to confirm inflammation; and when FC levels are >250 μg/g, active inflammation is likely and strategies to control inflammation should be initiated (eg, optimizing current therapies or switching to an alternative therapy).DISCUSSION: FC is a useful biomarker to accurately assess the degree of inflammation and should be incorporated into the management of patients with IBD.

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“…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].…”

Section: Faecal Calprotectinmentioning

confidence: 99%

“…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].…”

Section: Faecal Calprotectinmentioning

confidence: 99%