08-07-2014, 01:51 PM   #1
Sophalicious
 
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Fecal Calprotectin

Does a positive fecal calprotectin test always indicate IBD?
My almost 3year old daughter has suffered with constipation, blood in stool, mouth ulcers and failure to gain weight. She has also had fevers and stomach cramps. Stool sample has also detected occult blood and pus.
Are we right in fearing an ibd diagnosis?
08-07-2014, 01:55 PM   #2
DanceMom
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By "positive" do you mean elevated? If so, I don't think so. An elevated FC indicates inflammation in the gut which could be caused by IBD, an infection, an autoimmune condition, or even a virus.
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08-07-2014, 03:04 PM   #3
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Hi thanks for the reply. The result only states positive. I questioned if there should be a value at the lab and they responded that it was either positive (over a certain amount) or negative??
08-07-2014, 03:06 PM   #4
Farmwife
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Hi and welcome,
Do you have a number with that test result?

My girl is five but dx at three and she had most if not all of the same symptoms.
However there are other GI problems that could cause these things.
Do you see a pediatric gi?
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08-07-2014, 03:11 PM   #5
Farmwife
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Hi thanks for the reply. The result only states positive. I questioned if there should be a value at the lab and they responded that it was either positive (over a certain amount) or negative??
Was the test maybe called fecal lactoferrin?
08-07-2014, 03:22 PM   #6
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Hi guys thanks for the welcome. We had the test performed at a lab in Abu Dhabi where we are currently living for my husbands work. It just states 'fecal calprotectin-positive'.
I've had a look on the dreaded google and it appears to be the case that it implies IBD.
We are not able to speak to my daughters GI doctor for another few days.
08-07-2014, 04:21 PM   #7
Farmwife
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I think we might have another member in your area.
Tag Catherine , is your sister and nephew in this area?
It might be nice for you to meet other parents from the area (if we have any).

Does your child have allergies? There's allergic diseases that can mimic Ibd.
08-07-2014, 04:22 PM   #8
Maya142
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There are some things that can cause a false positive. I think using NSAIDs (such as Advil, Motrin) is one. I think certain infections are another.
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08-07-2014, 05:06 PM   #9
Catherine
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Yes my sister family and her family live in the UAE. I have Facebook messaged her.

Tagging Maree.
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Has previously taken Multi B, Caltrate, B12 & Iron

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08-07-2014, 05:46 PM   #10
Maree.
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Hi,

My son Liam had a really bad year 2012/2013 school year. He had constant mouth ulcers, severe stomach pains, reflux and weight loss. His calprotectin test came back very high however all the scopes we're clear.

Last year his health was reasonably good although his weight is still a bit low and we've stopped looking for answers.

We had calprotectin test done in UAE and the lab result was a specific number.

As long as your health insurance level is good UAE has some positives as a place to go through the diagnostic process as waiting times to see specialists and have tests done are generally very short compared to many other places. Waits to see specialists are generally days not weeks and if they decide to book scopes they can generally get these done in a week or two.

Medical care can be patchy in the UAE though as doctors come from a range of different backgrounds (so if you've got any concerns make sure you get 2nd and possibly 3rd opinons). Dubai has two pediatric gastroentrologists, only one of whom I'd be prepared to recommend. I'm afraid I don't no what the situation is with doctors in Abu Dhabi.
08-07-2014, 08:07 PM   #11
CrohnsKidMom
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Welcome to the forum. I'm sure being away from home and family and friends has added to this stress. Your daughter's symptoms sound a lot like my son's when he was dx'd last yr. But, like the others have said, it could be something else. I hope you get great medical care and your daughter gets on the road to feeling well soon. Take care.
08-07-2014, 10:47 PM   #12
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Morning all! Thanks so much for the responses. We are very lucky that things move fast out here and the GI doctor we are under used to work in a very large hospital in London so I'm hoping we are in good hands. They are eager to do a colonoscopy but we obviously wanted to wait until we had all the blood and stool tests back.
Sophie's three stool samples over the last 6 weeks have shown occult blood/pus cells. We have seen blood four times. The calprotectin has only been tested once which was yesterday and it came back positive. Maybe they will repeat this and I can ask that it be done in a lab that provides a value.
Sophie had reflux as a baby and has always suffered with constipation but no allergies we know of.
It has only really been the last few months that we have noticed an change in her. She has always been very energetic but has definitely slowed down and is very pale. Her blood tests have not shown her to be anaemic however.
She has stomach cramps and mouth ulcers and has not put on weight for nearly a year.
She had a bladder infection a few months ago which was treated with antibiotics and has not been right since. She has vomited a few times in the night. One of which was just bile.
On Saturday she had a day of severe (15 times) bloody diarrhea and then Monday a huge fever (104) which I could not control. We are not allowed to use NSAIDs because of the bleeding and paracetamol would only bring it down one degree. They ended up putting her on iv paracetamol and antibiotics as they could see a lot of inflammation in her mouth/throat. She however never behaved like she had a sore throat and had a healthy appetite as always.
One doctor at the hospital mentioned that if she had ibd it could make an infection worse and that it can also cause problems in the mouth.
Sorry to waffle on. I'm very nervous and was hoping the fecal calprotectin positive could be due to something else. Very positive to hear that could be the case. Maybe it is due to her throat infection? Thank you all so much!
08-08-2014, 03:05 AM   #13
Catherine
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I wondering whether you have received the full results of the faecal calprotectin as the results usually take longer. In Australia it takes two weeks.
08-08-2014, 03:32 AM   #14
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Oh really?! These were available in two hours : /
08-08-2014, 03:34 AM   #15
Catherine
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I have Facebook my sister to see how long her son results took.
08-08-2014, 04:30 AM   #16
my little penguin
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Ours took a week as well to get results but that is the one lab they send out .
Sorry to hear about the fever .
Did they do other stool tests ( infection)?
Hope they can get her in for the colonscopy soon .
That is the good standard and will help get to the bottom of it quickly.
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08-08-2014, 07:03 AM   #17
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Hi guys thanks very much. They have sent off a culture which will be back on Monday x
08-08-2014, 06:30 PM   #18
Maree.
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Liam had Calproc tested twice in 2013 it took ~10 days each time in Dubai.
08-08-2014, 10:39 PM   #19
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Hmmm ok I will definitely be asking about this result then. Thanks for you help.
08-09-2014, 01:30 AM   #20
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Ok so the lab said that they do the fecal calprotectin in house and confirmed it is completed within two hours. Strange. Maybe it is a new thing. Anyhow the gi doctor has stated that Sophie requires an endoscopy which we were hoping to avoid but needs must : (
08-09-2014, 07:35 AM   #21
my little penguin
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The scope is harder on the parents than the kid.
Good luck
Hope you get quick results and abswers so she can get better.
08-09-2014, 07:37 AM   #22
DanceMom
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You still need to know the number associated with her results. "Positive" doesn't really give much information. Glad you are having scopes done though. They really aren't as bad as you think.
08-10-2014, 06:34 AM   #23
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It's so strange that the lab are adamant that they have no value. They just say if it's positive it means it's above the normal or borderline levels! But how above??
We received her culture back which is negative for any kind of bacteria etc.
Unfortunately the doctors/labs aren't filling us with confidence.
Maree would you be prepared to recommend your gi doc in Dubai please?
08-10-2014, 07:27 AM   #24
Maree.
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This is a test where you should have a number. We started with an adult GI at our local clinic who did the basic tests including the Calproc.

We then saw two Pediatric Gastoentrologists, we we're very happy with the 2nd one, Dr Shamar who is based in the Mediclinic Dubai Mall. Dr Shamar is an Indian pediatrician but has done further study (and worked) in US & UK. His Pediatric Gastroentrology training was done in the US.

http://www.mediclinic.ae/DoctorDetails.aspx?drid=369
08-10-2014, 07:53 AM   #25
Sophalicious
 
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That's great thank you so much Maree.
The whole fecal
Calprotectin postive thing seems very strange. Would be a nice thought to think they had done something incorrectly and she doesn't actually have elevated calprotectin!
Thanks again!
08-10-2014, 07:55 AM   #26
Maree.
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Will also mention the adult GI had the calproc run twice. He ordered the 2nd one about a week after the first one came back high. He said he wanted to eliminated the possibility of lab error or some sort of passing infection that had caused a temporary elevation.
08-10-2014, 08:55 AM   #27
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I will definitely be asking for it to be repeated and that a value is provided!
Thanks again!
08-10-2014, 12:58 PM   #28
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So apparently there are two different kinds of fecal calprotectin tests. One is qualitative which is what we had done. This will only state negative, borderline or positive. The other is called quantitative whereby you are provided a value.
Thought I would put this on here incase anyone else is ever in the same predicament.
11-17-2014, 02:19 AM   #29
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Hi guys! So after a couple of month of Sophie being on great form after her iv antibiotics we have recently had another bout of blood in stool, huge fever, stomach pain and mouth ulcers.
After her original qualitative positive calprotectin the last three have been absolutely fine with the number around the 30 mark. Her blood tests are all good apart from high monocytes and the bottom of the normal
Range for zinc.
We are currently consulting with Dr Sharma as recommended. He has run some specific blood tests for Ibd. One was for neutrophil antibodies and I believe the other was regarding something to do with Iga levels.
My question is... Can calprotectin come back normal if a child has IBD?
Two pediatric Gi doctors along with Sophie's paediatrician all seem to think she could have IBD but one is very reassured by the recent low calprotectin and wants to wait and see.
The paediatrician and the other GI doc want her to have scopes regardless.
Obviously we want a diagnosis or for IBD to be ruled out but are also worried about her going under General anaesthetic and having the procedure due to any complications.
Any thoughts or experience on the normal calprotectin?
11-17-2014, 06:56 AM   #30
Catherine
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What color is the bleeding?
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