Fecal calprotectin level not consistent in IBD

Last Updated: 2015-12-31

By David Douglas

NEW YORK (Reuters Health) - Levels of fecal calprotectin, a biomarker of intestinal inflammation, vary in patients with inflammatory bowel disease (IBD), according to Norwegian researchers.

As Dr. Vendel Kristensen of the University of Oslo told Reuters Health by email, "Our results demonstrate that intra-individual f-calprotectin variability is present and substantial."

For the study, online December 4 in the Scandinavian Journal of Gastroenterology, 50 patients provided three feces samples on two consecutive days (from the morning, the evening and the following morning).

The two morning samples differentiated between mucosal inflammation and mucosal healing with the same level of agreement as the two samples from the same day. Although there were large intra-individual variation in f-calprotectin values, Dr. Kristensen and colleagues report, there were no significant day-to-day or diurnal variations.

The researchers did not find morning sampling superior to sampling later at the day. However, "around one out of 10 patients in our study had values of f-calprotectin on each side of the proposed cut-off level for mucosal healing," they write.

In the second part of the study, 19 patients provided two feces samples from the same bowel movement. For one, they used a conventional sampling tube with a spoon in the lid from Roche, while for the other they used a device for patient-administered sampling and extraction (Calex, Buhlmann Laboratories).

The latter approach appeared generally feasible, although two patients provided samples leading to considerably higher f-calprotectin levels than the conventional sampling procedure.

The new extraction method is reliable when used by laboratory technicians, say the researchers, "but larger studies are recommended to evaluate patient administered extraction."

Dr. Kristensen concluded that although overall "the variation seemed of clinical interest in a minority of our patients, we would recommend at least two consecutive f-calprotectin measurements when these are used to guide treatment in IBD patients."

One of the authors receives consultant fees from Buhlmann Laboratories.

SOURCE: http://bit.ly/1YIPHkN

Scand J Gastroenterol 2015.