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High Fecal Calprotectin normal bloodwork

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Posted 11/22/2014 9:47 PM (GMT 0)
Looking for input....
Last visit with my son at the GI was great--normal blood-work (everything in range--SED, CRP, etc.), no symptoms (ulcers, rashes, blood in poop, etc), he's gaining weight and a tad bit in height. All was good. Just got his fecal calprotectin results back and they are extremely high. I'm a bit concerned by what this may mean. Thoughts???
Posted 11/22/2014 10:45 PM (GMT 0)
Fecal calprotectin is a pretty good indicator of inflammation in the colon. If you graph fecal calprotectin versus endoscopic severity, there's a pretty clear correlation.

Having said that, it *can* be high in some people with just mild inflammation; and it can be low in *some* people with significant inflammation. It's not a perfect indicator.

But it is a pretty good indicator, probably better than ESR/SED or CPR. So if I were you I'd be a bit concerned. When was your son's most recent colonoscopy?
Posted 11/23/2014 12:56 AM (GMT 0)
His colonoscopy was just a few months ago. Everything has been improving since he's been on medication and at our last GI visit--about 15 days ago--she said everything looked great and to see her in January. She said to call to review the FCP test results which I actually forgot to do and which I will do immediately on Monday. Yes, I am definitely concerned based on the results--it's just hard since everything else is going well and I wonder if this is a baseline test since he's not had it done before. Perhaps when he was first diagnosed if the test was performed it would have been higher--I don't know. Do you think they'd up his medication (Pentasa) or try something different (steroids) as a short-term fix or wait a bit and test it again? I appreciate your feedback.
Posted 11/23/2014 1:14 AM (GMT 0)
When I was at my sickest point, my fecal calprotectin was 1538 but the rest of my bloodwork and crp was dead normal. I was thankful my misery was validated by the fcp. I started ldn and my repeat fcp a month later dropped to 18 and it correlated with how good I was feeling. It is an accurate predictor for a flare up in my case.

If your son is feeling better, they may up what he is taking now or add something to the mix and then retest .
Posted 11/23/2014 1:51 AM (GMT 0)
Is he on any proton pump inhibitors?  These can contribute to an elevated Calprotectin number
Posted 11/23/2014 2:18 AM (GMT 0)
Eridon:
He's on Prevacid which I think is a PPI. So you're saying it's possible that taking PPI will result in an elevated fcp? I'll ask the GI on Monday and greatly appreciate the information.
Posted 11/23/2014 4:17 AM (GMT 0)
Here is a link on fecal calprotectin and its use in IBD monitoring:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520167/

With this being his first measurement of fecal calprotectin, you can't know whether it's going up, or down, or staying steady.

You could wait and do it again in another month or so. Or you could have him do another colonoscopy. Or if he has disease in the sigmoid and/or left colon, perhaps just a sidmoidoscopy can tell the doc if he's getting any better.
Posted 11/23/2014 4:19 AM (GMT 0)
And yes, eridon is correct that PPIs (such as Nexium, aciphex, and prevacid) can cause elevated fcp levels. That's a good point.
Posted 12/26/2014 7:42 PM (GMT 0)
Thanks all. The doctor had us take him off Prevacid for a couple weeks and had him retested. His fcp level is now less than half of what it was. Still not in the normal range but going in the right direction. We'll see what the doctor wants to do in January. Happy Holidays all-and thanks again.
Posted 12/26/2014 8:33 PM (GMT 0)

beave said...
And yes, eridon is correct that PPIs (such as Nexium, aciphex, and prevacid) can cause elevated fcp levels. That's a good point.

NSAIDs (ibuprofen, etc.) are known to cuase elevated FCP levels as well.
Posted 12/29/2014 12:22 AM (GMT 0)
What was his level? Our GI said it can take a while for it to come down once starting treatment, but as long as it keeps moving in the right direction, then it's ok (per our GI). My sons started at 800+, 6 weeks after starting meds it was 530. We go back in a few days, and will test again...dr was happy with the direction it was going.
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