Please ensure that stool samples are not over-filled, nor under-filled. We require a minimum volume of 2 heaped scoops (i.e. the scoop that is connected to the stool container) and a maximum volume that is half full.
Calprotectin questions on ICE must be completed or please complete special form required from Primary Care (Calpr – loads PDF)
If Inflammatory Bowel disease is suspected in Primary Care for patients aged 4 Y – 49 Y, perform Faecal Calprotectin (FC).
Please be aware of changes to the Calprotectin cut off values will come into effect from 18/11/20 to align with the Devon Formulary.
Values <100 ug/g fall within the reference range and are not suggestive of gastro-intestinal inflammation (currently <50 ug/g). If previously diagnosed with IBD, the level would indicate a period of remission.
Values >/= 100ug/g are suggestive of gastro-intestinal inflammation: possible causes include IBD, infection, polyps, neoplasia and NSAID’s. If previously diagnosed with IBD, consistent with active disease.
Further information can be found at: https://northeast.devonformularyguidance.nhs.uk/referral-guidance/eastern-locality/gi-liver/irritable-bowel-syndrome-ibs-diagnosis-and-management-for-adults-under-the-age-of-50
Please note, the age related reference ranges for patients less than 4 years old is as follows:
|Age||Reference range Faecal Calprotectin (ug/g faeces)|
|up to 6 months||< 800|
|6 months > 12 months||< 600|
|12 months > 2 years||< 400|
|2 years > 4 years||< 200|
Consider referral to paediatric gastroenterology if FC result exceeds the top of the age-related reference range.
Calprotectin is a 36 kDa calcium and zinc binding protein. It accounts for 60% of neutrophils cytosol. In vitro studies show it has bacteriostatic and fungistatic properties. It is resistant to enzymatic degradation, and can be easily measured in faeces.
Inflammatory bowel diseases (IBD) are a group of conditions that cause a pathological inflammation of the bowel wall. Neutrophils influx into the bowel lumen as a result of the inflammatory process. Measurement of faecal calprotectin has been shown to be strongly correlated with 111-indium-labelled leucocytes – considered the gold standard measurement of intestinal inflammation.
Diseases causing increased excretion of faecal calprotectin include Crohn’s Disease, Ulcerative colitis and neoplasms (cancer) have all been shown to raise faecal calprotectin levels. Levels of faecal calprotectin are normal in patients with irritable bowel syndrome (IBS).
Calprotectin may be used to
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We welcome referrals for Anti TNF monitoring. If you are a new requestor please complete the following form: New requestor form
Our Quality Statement for referred work can be found here : Quality statement May 2019 (405 downloads)Specimen Labelling Procedure