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HelpTest Code MALP Malabsorption Evaluation Panel, Feces
Specimen Required
Supplies: Malabsorption Panel (T920)
Container/Tube: Malabsorption kit or 2 small stool containers
Specimen Volume: 18 g split between 2 containers, each containing half of the specimen
Collection Instructions:
1. Collect a fresh, random fecal specimen, no preservative.
2. Split specimen between 2 small containers, each containing half of the specimen.
3. Label one small container with the A1AF and UREDF sample collection labels. Label the other small container with the CALPR, ELASF sample collection label.
4. Freeze immediately
Additional Information:
1. Specimen must be split prior to transport.
2. Testing cannot be added to a previously collected specimen.
3. Specimen cannot be collected from a diaper.
Useful For
Evaluation of patients with suspected malabsorption, as suggested by chronic diarrhea, unexplained weight loss, or nutritional deficiencies
Differentiation between causes of malabsorption, specifically inflammatory conditions, pancreatic insufficiency, and osmotic diarrhea
Detection of protein-losing enteropathy that may be associated with an underlying malabsorption
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| A1AF | Alpha-1-Antitrypsin, Random, F | Yes | Yes |
| CALPR | Calprotectin, F | Yes | Yes |
| ELASF | Pancreatic Elastase, F | Yes | Yes |
| UREDF | Reducing Substance, F | Yes | Yes |
Method Name
A1AF: Nephelometry
CALPR, ELASF: Enzyme-Linked Immunosorbent Assay (ELISA)
UREDF: Benedict’s Copper Reduction Reaction
Reporting Name
Malabsorption Evaluation Panel, FSpecimen Type
FecalSpecimen Minimum Volume
5 g
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Fecal | Frozen | 7 days |
Reference Values
ALPHA-1-ANTITRYPSIN, RANDOM:
≤54 mg/dL
CALPROTECTIN:
<50.0 mcg/g (Normal)
50.0-120 mcg/g (Borderline)
>120 mcg/g (Abnormal)
Reference values apply to all ages.
PANCREATIC ELASTASE:
<100 mcg/g (Severe pancreatic insufficiency)
100-200 mcg/g (Moderate pancreatic insufficiency)
>200 mcg/g (Normal)
Reference values apply to all ages.
REDUCING SUBSTANCE:
Negative or trace
Interpretation
Calprotectin concentrations above 120 mcg/g are suggestive of an active inflammatory process within the gastrointestinal system; additional diagnostic testing to determine the etiology of the inflammation is suggested.
Calprotectin concentrations between 50.0 and 120 mcg/g are borderline and may represent a mild inflammatory process; for patients with clinical symptoms suggestive of an inflammatory process, retesting in 4 to 6 weeks may be indicated.
Pancreatic elastase concentrations below 100 mcg/g are consistent with exocrine pancreatic insufficiency; pancreatic elastase concentrations from 100 to 200 mcg/g are suggestive for moderate exocrine pancreatic insufficiency.
Reducing substance concentrations above 0.50 g/dL are consistent with grade 2 to 4 osmotic diarrhea; reducing substance concentrations from 0.25 to 0.50 g/dL are consistent with grade 1 osmotic diarrhea.
Alpha-1-antitrypsin concentrations above 100 mg/dL are consistent with protein-losing enteropathy
Clinical Reference
1. Levitt DG, Levitt MD. Protein losing enteropathy: comprehensive review of the mechanistic association with clinical and subclinical disease states. Clin Exp Gastroenterol. 2017;10:147-168
2. Murray FR, Morell B, Biedermann L, Schreiner P. Protein-losing enteropathy as precursor of inflammatory bowel disease: a review of the literature. BMJ Case Rep. 2021;14(1):e238802
3. Gisbert JP, McNicholl AG. Questions and answers on the role of faecal calprotectin as a biological marker in inflammatory bowel disease. Dig Liver Dis. 2009;41(1):56-66
4. Sherwood RA, Walsham NE, Bjarnason I. Gastric, pancreatic, and intestinal function. In: Rifai N, Horwath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:1398-1420
5. Capurso G, Traini M, Piciucchi M, Signoretti M, Arcidiacono PG: Exocrine pancreatic insufficiency: prevalence, diagnosis, and management. Clin Exp Gastroenterol. 2019;12:129-139
6. Chowdhury SD, Kurien RT, Ramachandran A, et al. Pancreatic exocrine insufficiency: Comparing fecal elastase 1 with 72-h stool for fecal fat estimation. Indian J Gastroenterol. 2016;35(6):441-444
7. Siddiqui HA, Salwen MJ, Shaikh MF, Bowne WB. Laboratory diagnosis of gastrointestinal and pancreatic disorders. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. Elsevier; 2017:306-323
8. Branski D. Disorders of malabsorption. In: Kleigman RM, Stanton BF, St.Geme JW, eds. Nelson Textbook of Pediatrics. Elsevier; 2016:1831-1850
9. Krom FA, Frank CG. Clinitesting neonatal stools. Neonatal Netw. 1989;8(2):37-40
10. Sacks DB. Carbohydrates: Qualitative methods for total reducing substances. In: Burtis CA, Ashwood ER, eds. Tietz Textbook of Clinical Chemistry. 2nd ed. 1994;968-969
Day(s) Performed
Monday through Friday
Report Available
4 to 6 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
See Individual Test IDsCPT Code Information
0430U
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MALP | Malabsorption Evaluation Panel, F | 101803-5 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| ELASF | Pancreatic Elastase, F | 25907-7 |
| 6215 | Reducing Substance, F | 11060-1 |
| AAT_F | Alpha-1-Antitrypsin, Random, F | 9407-8 |
| CALPR | Calprotectin, F | 38445-3 |
Forms
If not ordering electronically, complete, print, and send Gastroenterology and Hepatology Test Request (T728) with the specimen.