Fecal Leukocytes (LAB6018) and Lactoferrin, Fecal by ELISA (Misc LAB000, MayoID: FLACF)

Lactoferrin is indicated to screen patients with concerning for inflammatory bowel diseases

Clinical Background
  • A positive lactoferrin may be a useful test to screen patients with chronic abdominal pain and diarrhea, concerning for inflammatory bowel diseases (IBD). It is less invasive and more cost-effective than colonoscopy.
  • Lactoferrin is a marker of fecal leukocytes, and testing is performed by enzyme-linked immunosorbent assay (ELISA).
  • Fecal leukocytes testing is a manual stain of fecal material test, looking for intact WBC cells.
  • Infectious GI manifestations are NOT an indication for lactoferrin or fecal leukocyte testing.
Common Pitfalls
  • A negative lactoferrin result does not exclude the presence of intestinal inflammation.
  • Fecal leukocyte testing is not indicated for investigation of infectious GI diseases. More appropriate tests for infection may include stool culture, C. difficile test, or ova & parasites stool examination, depending on the clinical scenario.
Key Takeaways
  • Fecal leukocytes stain is not recommended for investigation of any type of GI symptoms given the low sensitivity and specificity.
  • Lactoferrin is indicated only for individuals presenting with chronic abdominal pain and diarrhea, to aid in the differentiation between IBD and functional gastrointestinal diseases such as irritable bowel syndrome.
References
  1. Kane S et al.  Am J Gastroenterol. 2003;98(6):1309-14.
  2. Abraham B & Kane S.  Gastroenterol Clin North Am. 2012;41(2):483-95.

Written by: Patricia Hernandez, MD

Reviewed by: Allison Eberly, PhD

Last Edited: 2024-04-09

Last Reviewed: 2024-04-09