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Calprotectin test

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Ulcerative Colitis
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Posted 3/17/2021 9:29 PM (GMT -5)
I was diagnosed with UC about 4 years ago. I was put on apriso max dose and would have to be put on 5 weeks of prednisone every 6 months to a year because I would start having 5ish bowel movements a day. My colonoscopies visually never looked bad but the biopsies have always shown mild to moderate inflammation. We tried Imuran and I had a bad reaction so we moved onto Humira January of 2020. It seemed to help a lot but I would try to decrease my Apriso and never could. I would start to see mucus and blood.

My recent blood test showed low potassium and anemia (I have fought with anemia before diagnosis). So my Doctor ordered a c reactive protein test - results were - .3 and a calprotectin fecal test - results were - 205. So one shows no inflammation and the other inflammation? Does this mean the Humira isn’t working? I am not really having urgency ( stools totally formed sometimes constipated which is normal for me) and I only have seen a bit of mucus and/or red blood once or twice in the last month or two ( I do have hemorrhoids). I just got the results so I have to wait for my doctor to see them.
Posted 3/18/2021 2:10 AM (GMT -5)
205 is not a very high result. I think normal is under 150. I've seen people with results in the 1000s. Perhaps you could do a retest in the near future and see if it's improved but I personally wouldn't think the worst over 205.
Posted 3/18/2021 6:17 PM (GMT -5)
Ok thanks - I don’t have any symptoms right now so crossing fingers it’s just a blip. I do have Mesalamine enemas that I stopped a month after starting Humira so maybe I will start those again. Have not heard from my doctor yet.
Posted 3/18/2021 9:43 PM (GMT -5)
Absolutely start the mesalamine enemas. Do you have enough refills to be on them for a bit?

Hopefully, your doc will call tomorrow.

q
Posted 3/18/2021 10:28 PM (GMT -5)
Twingirls, have you had any fecal calpro tests in the past? If so, what were the results? It's better to compare with your own past results than with results from others. Some people's fecal calpro skyrockets with inflammation, while for others it only goes up modestly with similar inflammation. In general, the higher the result, the more inflammation, but it's not a perfect correlation.

Also, are you on any other meds for any other conditions? Some medications can elevate fecal calpro results.

When was your last colonoscopy or sigmoidoscopy?
Posted 3/19/2021 10:36 PM (GMT -5)

beave said...
Twingirls, have you had any fecal calpro tests in the past? If so, what were the results? It's better to compare with your own past results than with results from others. Some people's fecal calpro skyrockets with inflammation, while for others it only goes up modestly with similar inflammation. In general, the higher the result, the more inflammation, but it's not a perfect correlation.

Also, are you on any other meds for any other conditions? Some medications can elevate fecal calpro results.

When was your last colonoscopy or sigmoidoscopy?

I have not had one in the past. I had the C-reactive protein and that is lower but has always been within normal range. My last colonoscopy was 18 months ago. I just have absolutely no symptoms. I have acid reflux so I am on medication from that and I had my 2nd covid shot about a week before the test. I have a month of the mesalamine enemas so I will do that until I hear back from my Doctor. They sent me a message yesterday saying they have all the test results and the Dr is reviewing.
Posted 3/19/2021 11:44 PM (GMT -5)
Since you haven't had fecal calpro tests in the past to compare with, it's hard to know how to interpet 205. For example, if you'd had a 1400 when flaring before and now it's 205, you'd consider 205 pretty low. But if you'd had only 250 when flaring badly, a 205 for you would mean inflammation is likely.

One reason I asked about other meds is that ppi's (used to treat reflux) are known to increase fecal calpro results in some people. So if you're taking a ppi, that makes your 205 result even harder to interpret.

You're probably due for a scope if it has been 18 months and you started Humira a little over a year ago. Or if not a full colonoscopy, at least a sigmoidoscopy, (full scope more appropriate if you had pancolitis, sigmoidoscopy more appropriate if you had only inflammation in rectum, sigmoid).
Posted 3/28/2021 10:41 PM (GMT -5)

beave said...
Since you haven't had fecal calpro tests in the past to compare with, it's hard to know how to interpet 205. For example, if you'd had a 1400 when flaring before and now it's 205, you'd consider 205 pretty low. But if you'd had only 250 when flaring badly, a 205 for you would mean inflammation is likely.

One reason I asked about other meds is that ppi's (used to treat reflux) are known to increase fecal calpro results in some people. So if you're taking a ppi, that makes your 205 result even harder to interpret.

You're probably due for a scope if it has been 18 months and you started Humira a little over a year ago. Or if not a full colonoscopy, at least a sigmoidoscopy, (full scope more appropriate if you had pancolitis, sigmoidoscopy more appropriate if you had only inflammation in rectum, sigmoid).

Interesting about the PPI. I am on one. My Dr sent me a message asking how I am feeling. I told him I currently am feeling fine. Currently I have no signs of a flare like I have had in the past so I guess we will see what he says.
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