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IBD Expanded Panel Enzyme immunoassay

Test ID:

706247

CPT code:

86671, 83516 (x3), 86255

Synonyms:

Atypical pANCA

Glycominds

IBDX

Inflammatory Bowel Disease (IBD) Expanded Profile

Clinical Use:

Aids in the diagnosis of inflammatory bowel disease (IBD) and the differential diagnosis of Crohn’s disease (CD) and ulcerative colitis (UC); prognostic aid for clinical management of patients with CD.

Test Information:

Inflammatory bowel disease is a chronic disorder of the lower gastrointestinal tract that may occur in three forms: Crohn’s disease (CD), ulcerative colitis (UC), and indeterminate colitis (IC). Its prevalence in the adult population approaches 0.3%. The differential diagnosis of the different forms of IBD is often difficult, time-consuming, and invasive. The gold standard for diagnosis is endoscopy with biopsies for histologic examination. In recent years, however, a number of serological markers have been introduced. The most commonly employed serological markers of IBD are anti-Saccharomyces cerevisiae antibody (ASCA) and atypical perinuclear antineutrophil cytoplasmic antibody (pANCA). ASCA positivity is found predominantly in patients with CD, while pANCA positivity is found predominantly in patients with UC. A combination of ASCA and pANCA has a specificity of as high as 99% for differentiation of CD from UC. Nevertheless, there are a substantial number of patients with IBD who are negative for both. The addition of novel serological markers improves the sensitivity of the conventional ASCA/pANCA combination.
About two-thirds of patients with CD develop either a stricturing or penetrating disease course within 10 years after diagnosis. As many as 80% of all CD patients undergo surgery at least once during the course of their disease. Consequently, the identification of individuals susceptible to the development of more complicated disease behavior would allow for earlier and more aggressive treatment.
This profile offers three novel markers: antichitobioside IgA (ACCA), antilaminaribioside IgG (ALCA), antimannobioside IgG (AMCA), together with anti-Saccharomyces cerevisiae IgG (gASCA) and pANCA. These markers provide additional diagnostic and prognostic information depending on the combination of results.
The antibodies included in the panel are ASCA (anti-Saccharomyces cerevisiae antibodies), ALCA (antilaminaribioside carbohydrate antibodies), ACCA (antichitobioside carbohydrate antibodies), and AMCA (antimannobioside carbohydrate antibodies). Numerous studies of CD have demonstrated an association between ileal disease and the presence of ACCA, ALCA, AMCA, and ASCA. Among these antibodies, the association with localization to the small intestine increased with the number of positive antibodies and with the concentration of individual antibodies. A more aggressive or complicated disease course in CD (as indicated by stricturing or perforation of the intestine or need for surgery), has also been associated with the presence of ACCA, ALCA, AMCA, and ASCA. Among these antibodies, the association with complicated disease behavior or surgery increased with the number and concentration of antibodies.