The Reliability of Patient-Performed Fecal Calprotectin Testing in Inflammatory Bowel Disease

Lies E. J. L. Dijkhuis, Femke Crouwel, Marjolijn Duijvestein, Hans J. C. Buiter, Nanne K. de Boer, Henrike M. Hamer

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: Home use of a buffer-containing extraction device for fecal calprotectin determination can bypass the labor-intensive extraction procedure and potentially prevent degradation at room temperature. METHODS: In this prospective cross-sectional observational study, 2 CALiaGold tubes (extraction device) and one native tube were filled from the same bowel movement by patients with inflammatory bowel disease. Afterwards patients completed a questionnaire including whether they preferred the extraction device or the normal sampling method. All tubes were sent to the laboratory and when they arrived, 2 more CALiaGold tubes were filled at the laboratory from the native sample. The fecal calprotectin concentrations in all tubes were measured by a particle-enhanced turbidimetric immunoassay. RESULTS: Fifty-three patients were included in the study. Fecal calprotectin levels were significantly higher in samples extracted by the patient compared to the analyst-performed extractions. When patients were divided into 3 groups (i.e., fecal calprotectin levels <50 ug/g, 50 to 200 µg/g, and >200 µg/g) a substantial concordance was found (Cohen kappa 0.654). Patients sampling imprecision was higher (P < 0.018, median CV 16%) compared to the analyst. Most patients preferred this extraction device. CONCLUSIONS: Patient-performed fecal calprotectin extraction seems a realistic alternative sampling method and is preferred by most patients.

Original languageEnglish
Pages (from-to)319-329
Number of pages11
Journalthe Journal of Applied Laboratory Medicine
Issue number2
Publication statusPublished - 1 Mar 2023

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