Calprotectin, Fecal Quantitative

Test ID: 

702818

CPT code:

83993

Clinical Use:

An in vitro diagnostic to aid in the diagnosis of inflammatory bowel disease (IBD), Crohn’s disease, and ulcerative colitis, and to differentiate IBD from irritable bowel syndrome (IBS) in conjunction with other clinical and laboratory findings.

Additional Test Information:

Various types of organic disease in the gastrointestinal tract will cause damage to the intestinal lining (mucosa layer). Such damage may vary from increased permeability of the mucosa to inflammation, which may be toxic or chemotactic (ie, they stimulate leukocytes, in particular polymorphonuclear granulocytes [PMNs] to migrate into the gut lumen where they release their contents, including antimicrobial substances like calprotectin). This protein constitutes about 60% of total proteins in the cytoplasm of PMN and can be estimated in small, random stool samples even after storage for seven days at ambient temperature. The concentration of calprotectin in stool reflects the number of PMNs migrating into the gut lumen. Calprotectin is a calcium- and zinc-binding protein produced by PMNs, monocytes, and squamous epithelial cells, except those in normal skin. After binding calcium, it can resist degradation by leukocytic and bacterial enzymes. By competing with different enzymes for limited local amounts of zinc, calprotectin may inhibit many zinc-dependent enzymes and thereby kill microörganism or animal and human cells in culture. Calprotectin can be detected even in small (<1 g) random stool samples. Furthermore, organic diseases of the bowel give a strong fecal calprotectin signal (ie, elevations are often five to several thousand times the upper reference in healthy individuals indicating intestinal inflammation). Patients with organic or functional abdominal disorders may have similar symptoms, and clinical examination alone may not be sufficient to support a specific diagnosis. Additionally, the calprotectin test has been demonstrated to be a marker of inflammatory bowel disease in both children and adult patients.Inflammatory bowel disease (IBD) (eg, ulcerative colitis and Crohn’s disease), may appear from early childhood to late adulthood, and the diagnosis is often delayed due to vague symptoms or reluctance to perform endoscopy and biopsy.

Specimen Type:

Stool (unpreserved, random)

Requested Volume: 

1 g

Minimum Volume: 

0.5 g

Container Type: 

Clean screw-capped plastic vial

Collection:

Do not contaminate outside of container; do not overfill container. Loose stools are acceptable.

Storage Instructions:

Stool specimens should be received by the laboratory within 10 days of collection. Samples are stable for four days before testing at 2°C to 8°C. Freeze at -20°C if samples will not be tested within four days. Stable frozen up to one year from collection. Temperature should not exceed 30°C during shipment.

Rejection Criteria

Serum or plasma received; stool contaminated with urine; specimen older than 10 days of collection before tested; samples taken from diapers unless portion taken has not been in contact with diaper material; preserved stool received

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