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Does Faecal Calprotectin Test Result Of 313 Indicate Refractory Crohn's Disease?
Question: Hi
I have a question about my daughter who is 11 and has Crohn's. She has been on Imuran since July (50mg initially, then 25mg one day 50 mg the next since Sept). Her 6TGN levels are now very high (1300) but fecal calceprotein is at 313. Does this indicate she is refractory and we need to change drugs?
I have a question about my daughter who is 11 and has Crohn's. She has been on Imuran since July (50mg initially, then 25mg one day 50 mg the next since Sept). Her 6TGN levels are now very high (1300) but fecal calceprotein is at 313. Does this indicate she is refractory and we need to change drugs?
Brief Answer:
Suggests relapse. Regimen needs modification.Combination therapy is an optn
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have checked the mentioned details. Indeed the elevated levels of fecal calprotectin ( > 120 µg/g ) indicates increased disease activity and hence relapse. Instead of monotherapy, combination therapy with infliximab plus azathioprine might be advisable. However, you need to get in touch with your treating physician who would be able to suggest the feasible options for you.
Regards
Suggests relapse. Regimen needs modification.Combination therapy is an optn
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have checked the mentioned details. Indeed the elevated levels of fecal calprotectin ( > 120 µg/g ) indicates increased disease activity and hence relapse. Instead of monotherapy, combination therapy with infliximab plus azathioprine might be advisable. However, you need to get in touch with your treating physician who would be able to suggest the feasible options for you.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Why would iron go up but Ferritin go down? We are considering a switch to infliximab with methotexrate-- as the heterozygous for TMPT seems to be affecting azathioprine metabolism
Brief Answer:
Your judgment is reasonable
Detailed Answer:
Thanks again for writing back.
Ferritin is stored iron. On the other hand transferrin acts as a carrier for iron. Although the iron saturation improved, it is a relative figure. Imagine the following figures:
100 / 20 = 5
80 / 10 = 8
In the second case, both the numerator as well as the denominator have decreased, but still the final result has increased. So, I hope that is the explanation behind the figures.
It is good to hear that you are considering combination of infliximab with methotrexate. However, you still need to discuss with your physician. 6-tgn is a metabolite of azathioprine and is produced due to metabolism of azathioprine, it does not affect metabolism of azathioprine. However enzyme thiopurine methyltransferase (TPMT) mediates certain steps and being herozygous might affect the metabolism of azathioprine. The elevation of its levels 6-TGN might indeed justify your plans of changing over from azathioprine.
Regards
Regards
Your judgment is reasonable
Detailed Answer:
Thanks again for writing back.
Ferritin is stored iron. On the other hand transferrin acts as a carrier for iron. Although the iron saturation improved, it is a relative figure. Imagine the following figures:
100 / 20 = 5
80 / 10 = 8
In the second case, both the numerator as well as the denominator have decreased, but still the final result has increased. So, I hope that is the explanation behind the figures.
It is good to hear that you are considering combination of infliximab with methotrexate. However, you still need to discuss with your physician. 6-tgn is a metabolite of azathioprine and is produced due to metabolism of azathioprine, it does not affect metabolism of azathioprine. However enzyme thiopurine methyltransferase (TPMT) mediates certain steps and being herozygous might affect the metabolism of azathioprine. The elevation of its levels 6-TGN might indeed justify your plans of changing over from azathioprine.
Regards
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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