Calprotectin levels in normal range. Does this happen with Crohn's when you aren't on meds?

[prettyflowers]

Hello.

A doctor I saw recently has said that he is 99% sure I have Crohn's and is recommending Skyrizi. I am scheduled to start my first infusion this coming Thursday.

I am still somewhat skeptical of this diagnosis and this week requested to be tested for Celiac disease as well as asked for another calprotectin test before I start a life of biologics.

The results came in and the blood test indicated negative for Celiacs.

But, my calprotectin is in the normal range (26 ug/g) even though I was experiencing diarrhea at the time of stool collection (intermittent diarrhea has been my one and only outward physical symptom which caused me to see a doctor in the first place).

My question is this: Would I have completely normal calprotectin levels without being on any kind of medication right now? Especially when it has been elevated before.

It should be noted that my calprotectin levels have been tested multiple times over a few months apart in the last year with the following numbers: 296, 92, 817, and 196. I was put on budesonide one time. 817 level was the day I started budesonide and 196 level was at the end of taking budesonide.


Thank you for any input.

 

[Pangolin]

Did you have a colonoscopy? Calprotectin alone won't be sufficient to diagnose Crohn's, but all of those elevated calprotectin numbers are consistent with Crohn's.

 

[prettyflowers]

Did you have a colonoscopy? Calprotectin alone won't be sufficient to diagnose Crohn's, but all of those elevated calprotectin numbers are consistent with Crohn's.

Thank you for replying.

Yes, I had a colonoscopy which was clear save for a couple of polyps.

However, because of the diarrhea episodes (which came out of the blue one day) AND the high calprotectin, I had a capsule endoscopy and then an upper endoscopy. I had small ulcers in the jejunum (no where else) and they were biopsied. According to how I read the pathology report, I did not feel this specifically stated Crohn's for a diagnosis but my doctor feels 99% sure.


Pathology findings:
Small intestine, jejunum, biopsy: - Nonspecific acute duodenitis and enteritis with erosion - Negative for granulomas or viral cytopathic changes
The findings are nonspecific and can be seen in medication induced injury (e.g. NSAIDs), infections, peptic injury, among others.
The biopsy shows multiple fragments of small intestine mucosa some with Bruner's glands, consistent with duodenal mucosa. A mild to moderate acute inflammatory infiltrate is seen with associated reactive changes and focal erosion. No granulomas, viral cytopathic changes or definite chronic architectural changes are seen.

 

[valleysangel92]

Hello,

Looking at the combination of calprotectin and the biopsy results along with the capsule
Endoscopy it does seem like you may have crohns disease. Very often diagnosing these
Conditions is about pulling together information from various sources and eliminating other
Illnesses. With regard to your calprotectin it is possible to get a normal result even in the
Midst of a flare up. One normal result doesn't negate the multiple high readings or the
Symptoms you have experienced so if your doctor thinks it likely that you have crohns
Then you probably do.

 

[prettyflowers]

Hello,

Looking at the combination of calprotectin and the biopsy results along with the capsule
Endoscopy it does seem like you may have crohns disease. Very often diagnosing these
Conditions is about pulling together information from various sources and eliminating other
Illnesses. With regard to your calprotectin it is possible to get a normal result even in the
Midst of a flare up. One normal result doesn't negate the multiple high readings or the
Symptoms you have experienced so if your doctor thinks it likely that you have crohns
Then you probably do.

Thank you for replying. What you said here....

With regard to your calprotectin it is possible to get a normal result even in the
Midst of a flare up. One normal result doesn't negate the multiple high readings

is EXACTLY what I was curious about. I guess I was hoping that the normal calprotectin result (without being on any meds) might help to rule out Crohn's. Sounds like going from high to normal cal levels isn't unusual with Crohn's then.

Thank you for your input and helping me make sorts of this.

 

[Lynda Lynda]

My calpro levels

2018 = 420

2019 ?

2020 = 668

2021 = 568

2022 = 522

These numbers concern me.
I have not had my calprotectin checked in 2023 yet.

 

[Scipio]

Yes, those numbers are definitely elevated. Not super-high but high enough to justify your concern.

 

[Lynda Lynda]

Yes, those numbers are definitely elevated. Not super-high but high enough to justify your concern.

I sent a patient portal message to my GI office today to find out when I will be having my calprotecton level checked.