Fecal calproctectin yo-yo-ing

[eleanor_rigby]

Hello, anyone know why a fecal calproctectin test result might yo-yo?

Over the past year my results have been:

Aug 2015: 65
March 2016: 70
June 2016: 60
September 2016: 142
December 2016: 72
March 2017: 32
July 2017: 211

My MRI with contrast in September 2016 was normal, my colonoscopy in April 2017 was much improved - no visible redness and 3 tiny ulcers, biopsies were normal

 

[Guerrero]

Very good results except maybe the last one... congratulations.
I guess your doctor will have you retested 3 months later the last one.

No explanation regarding the yoyo, this disease is quite strange...

 

[eleanor_rigby]

Yes I will be retested in October and seeing my consultant in November. Strange as I had a colonoscopy 3 months before the 211 result and that looked pretty good and a marked improvement from my colonoscopy in December 2015 when my fecal calproctectin result was 65!

 

[Guerrero]

Colonoscopy is more important than those tests as they can monitor directly the mucosa.
what treatment are you on?

 

[eleanor_rigby]

Colonoscopy is more important than those tests as they can monitor directly the mucosa.
what treatment are you on?

I've been on azathioprine a year and 3 months. I'm in the UK so wouldn't be considered eligible for biologics.

 

[Guerrero]

Ok well, with those results probably azathioprine is effective enough

 

[Scipio]

One thing to consider is that stool is a much more variable substance day to day than is say blood. Thus, those results may not be yo-yo-ing so much as just "noise" in the ability of the lab to collect and process stool reproducibly. Since most of the numbers are pretty low, I wouldn't worry about them much. What you need to be concerned with are big swings and spikes that stay elevated.

 

[aypues]

those are great numbers. my yo-yo was like this:
810-818-202-380

 

[ncman]

I'll add my two-pence worth...

Calprotectin for me was a better indicator of disease activity than any other marker - after all, it measures the migration of white cells into the bowel.

If I was well and it was high, it predicted that I would be going into a flare, and needed to look at my dietary triggers. Likewise, if I was feeling ill, but the trend was going down, it was a sign that things were improving.

Generally speaking, anything below 200 wouldn't be a major cause for concern, but it's good to keep an eye on it.