Calprotectin

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Calprotectin is a calcium-binding protein with antimicrobial properties. It accounts for 60% of neutrophil cytosolic content and is also found in monocytes and macrophages. Calprotectin is released from the intestinal mucosa into the stool in intestinal inflammation. 

According to the literature, calprotectin levels can vary with age. It is higher in children younger than 5 years old due to increased intestinal mucosal permeability and differences in intestinal flora.

Fecal calprotectin for children between 2 to 9 years is considered normal if <166 mcg/g,

in individuals between 10 and 59 years if <51 mcg/g,

and after 60 years if <112 mcg/g.69

What does it mean if your Calprotectin result is too high?

An elevated level of Calprotectin in the GI – Advanced Profile from US BioTek indicates inflammation in the gastrointestinal (GI) tract.

Calprotectin is a protein found in white blood cells and is released during inflammation, especially in the intestines. High levels are commonly associated with inflammatory bowel diseases (IBD) like Crohn's disease or ulcerative colitis, but can also be present in other conditions like infections, colorectal cancer, and nonsteroidal anti-inflammatory drug (NSAID) use.

It's important to note that while elevated Calprotectin suggests inflammation, it does not specify the cause. Therefore, further diagnostic evaluation, such as colonoscopy or imaging, is often required for a definitive diagnosis.

Treatment options depend on the underlying condition causing the inflammation.

For IBD, management may include anti-inflammatory drugs, immune system suppressors, antibiotics, or biologic therapies. Dietary changes and supplements might also be recommended to manage symptoms. In cases of infection, appropriate antibiotics or antiviral medications will be necessary.

If the inflammation is due to NSAID use, discontinuing or replacing these medications may be advised.

Regular monitoring and follow-up tests are crucial to assess the effectiveness of the treatment and make any necessary adjustments.

Additional note: It's important for individuals with elevated Calprotectin levels to work closely with their healthcare provider to determine the most appropriate course of action based on their specific condition and overall health.

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Causes of elevated calprotectin:

- Age (children younger than 5 years old, and patients greater than 60)

- IBD, not in remission

- Colorectal cancer and polyps

- Infection (bacteria and some parasitic organisms)

- Non-steroidal anti-inflammatory medication use (NSAIDs) and NSAID enteropathy

- IBS patients may also have increased fecal calprotectin (at a much lower rate and level compared to IBD), indicating an inflammatory component to IBS (especially the diarrhea subtype). 

Therapeutic considerations for elevated calprotectin:

- Calprotectin 50 to 120 mcg/g

- Address cause of inflammation:

    --Infection

    --Suspected or history of IBD

    --Chronic NSAID use

- Recheck calprotectin in 4-6 weeks

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if Calprotectin >120 mcg/g:

Refer to your doctor to rule out IBD, malignancy, or other cause of significant GI inflammation.

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