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Calprotectin instability may lead to undertreatment in children with IBD

Sjoukje-Marije Haisma1, Patrick Ferry van Rheenen1, Lucie Wagenmakers2

  • 1Department of Pediatric Gastroenterology, Hepatology and Nutrition, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Archives of Disease in Childhood
|January 19, 2019
PubMed

Insights

Faecal calprotectin is unstable at room temperature, potentially leading to false reassurance in pediatric inflammatory bowel disease (IBD) monitoring. Refrigerating stool samples is crucial for accurate preanalytical handling and reliable IBD management.

Area of Science:

  • Biochemistry
  • Clinical Diagnostics
  • Pediatric Gastroenterology

Background:

  • Longitudinal tracking of fecal calprotectin (FC) aids treatment decisions in pediatric inflammatory bowel disease (IBD).
  • Limited data exists on the stability of fecal calprotectin during preanalytical sample handling.
  • Accurate FC measurements are vital for effective IBD management in children.

Purpose of the Study:

  • To evaluate the stability of fecal calprotectin in stool samples under different storage conditions.
  • To determine the impact of room temperature versus refrigeration on fecal calprotectin concentrations.
  • To assess calprotectin stability in assay-specific extraction buffers.

Main Methods:

  • Homogenized stool aliquots were stored at room temperature and 4°C for 6 days.
  • Calprotectin concentration was measured daily using three distinct assays.
  • Stability was also assessed in assay-specific extraction buffers at room temperature.

Main Results:

  • Fecal calprotectin showed significant degradation at room temperature, with mean percentage changes of 35% in stool and 46% in extraction buffer after 6 days.
  • Calprotectin stability was significantly better preserved in samples stored at 4°C (p=0.0066 for stool, p=0.0011 for buffer).
  • Assay-specific buffers did not fully preserve calprotectin at room temperature.

Conclusions:

  • Fecal calprotectin is not stable when stored at room temperature.
  • Inaccurate low calprotectin values due to degradation may mislead clinicians and families managing pediatric IBD.
  • Refrigeration of stool samples until laboratory delivery is the recommended preanalytical standard for maintaining calprotectin integrity.
Abstract

Keywords:
gastroenterologymonitoring

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