Someone posted recently that FCP results and norms can be different for small vs large bowel Crohn’s, or something similar. I can’t find it. Do any of you have info?
Fecal calprotectin (FC) is a highly sensitive disease activity biomarker in inflammatory bowel disease. However, there are conflicting reports on whether the diagnostic accuracy in Crohn’s disease is influenced by disease location. The aim of this study was to undertake a systematic review of the published literature. Relevant databases were searched from inception to November 8, 2016 for cohort and case control studies which had data on FC in patients with isolated small bowel (SB) and large bowel (LB) Crohn’s disease. Reference standards for disease activity were endoscopy, magnetic resonance imaging, computed tomography or a combination of these. The QUADAS-2 research tool was used to assess the risk of bias. There were 5,619 records identified at initial search. The 2,098 duplicates were removed and 3,521 records screened. Sixty-one full text articles were assessed for eligibility and 16 studies were included in the final review with sensitivities and specificities per disease location available from 8 studies. Sensitivities of FC at SB and LB locations ranged from 42.9% to 100% and 66.7% to 100% respectively while corresponding specificities were 50% to 100% and 28.6% to 100% respectively. The sensitivities and specificities of FC to accurately measure disease activity in Crohn’s disease at different disease locations are diverse and no firm conclusion can be made. Better studies need to be undertaken to categorically answer the effect of disease location on the diagnostic accuracy of FC.
Well....he is doing "great". But....Optimistic, you are scaring me asking this question. Things o.k. with your son?
Probably because FCP is FDA approved for diagnosis of IBD but not for monitoring the disease. Thus, if you are already diagnosed but are still doing FCP testing to check how you are doing, then you are monitoring - which is "experimental" from an FDA point of view. And of course an insurance company will seize on any excuse it can find to deny coverage, and in the case the FDA provides a perfectly good excuse that insurance companies are more than happy to embrace.We now pay for FCP out of pocket. It was approved and now it is experimental according to insurance. Not sure how that can be but whatever.
This is so odd because we were at that hospital for 7 years and we have never ever been told not to turn in FCP if my daughter had a cold or something. Maybe it's new research? But I thought it's gut specific? Does anyone know why it would change?? I know ESR and CRP can go up if the kiddo is sick but I always thought FCP was gut specific so that did not apply.Honestly I have no idea how much impact a minor illness causes on fcp
But new Gi team at new top ibd place flat out told Ds
Don’t bother turning it in
(They track fcp every 6 months as long as things are good )
Yup. That's because if the doc says "Crohn's" in the reason for the test the insurance company will not cover it because Crohn's is a diagnosis, and so from their point of view the diagnosis has already been made. But if he puts "diarrhea" that's a symptom and not a diagnosis, so they will cover it for the purpose of arriving at a diagnosis.^THAT!
Our GI gets around it by coding the test for "diarrhea" (which is not a lie) and "Crohn's small bowel". When he says, "Crohn's large intestine" they don't cover it. Also don't cover it when he says, "Crohn's large and small bowel". So weird.
I'm not sure how but I was able to get our PCP (family doctor) to write a requisition for it every 3 months. Maybe you can push it? Our GI does not offer it. Also in Ontario.It's not covered at all in Ontario Canada for any reason as far as I know--not by the government or extended health insurance plan I am with. It's $180 a pop.