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
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:
--Suspected or history of IBD
--Chronic NSAID use
- Recheck calprotectin in 4-6 weeks
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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