Diagnostic Value of Serological Assays in Pediatric Inflammatory Bowel Disorders

Abstract

Background: Pediatric studies reported that the combined use of the anti-neutrophil cytoplasm autoantibodies (ANCA) and the anti-Saccharomyces cerevisiae mannan antibodies (ASCA) may be a specific useful noninvasive test in the diagnosis of inflammatory bowel diseases (IBD). Aims: To evaluate the diagnostic accuracy of ANCA and ASCA in children with suspected IBD, and to see whether different commercially available assays (indirect immunofluorescence vs. ELISA) agree well enough in terms of analytical performance. Patients and Methods: Sixty-nine children (30 males, 39 females, age range 2–18 years) with suspicion of IBD entered the study. Before colonoscopy, a blood sample was also drawn to assess ASCA and ANCA. Results: A diagnosis of IBD was established in 47 patients; the remainder had infective or other causes of colitis. For ulcerative colitis, the association ASCA–/ANCA+ had 70% sensitivity and 86% specificity, with a positive predictive value of 82%. The association ASCA+/ANCA– had 86% sensitivity and 93% specificity for Crohn’s disease, with a positive predictive value of 75%. Conclusion: Although more experience is needed to state the diagnostic power of serologic assay, determination of ANCA and ASCA in IBD children may help both in distinguish these conditions from other entitiesand ulcerative colitis from Crohn’s disease, particularly in doubtful cases.

Serological Markers for Inflammatory Bowel Disease in AIDS Patients with Evidence of Microbial Translocation

“…To our knowledge, however, the present study is the first meta-analysis for all available IBD serological markers. Consistent with previous reports [25], [27], [29], [30], [34], [37], [79], [81], our meta-analysis demonstrated that the prevalence of ASCA IgA/IgG was 45% in CD subjects as compared to 7.9% and 3.7% in non-IBD and healthy controls, respectively, and pANCA was prevalent in 42.4% of UC subjects (Table 5) [26], [27], [29], [32], [37], [44], [82]. Anti-OmpC and anti-CBir1 were prevalent in 29.4% and 55.2% of CD subjects, respectively, compared to 17.6% and 25.5% in non-IBD disease controls, and 10.7% and 6.3% in healthy controls.…”

“…CD- Crohn's Disease; UC- Ulcerative colitis;*- any one of the antibodies present; Disease controls include inflammatory and non-inflammatory non-IBD disease controls (n = 633), including 264 non-IBD inflammatory gut diseases (i.e., colitis, gastroenteritis, celiac disease, etc); 193 non-inflammatory gut diseases (i.e., abdominal pain, diarrhea, lactose intolerance, etc); 90 rheumatologic disorders, and 86 other (i.e., constipation, nausea, rectal bleeding, etc).The meta-analysis includes 19 studies with CD patients [25], [27], [28], [29], [30], [33], [34], [35], [37], [42], [49], [52], [53], [55], [57], [58], [78], [79], [81], 12 with UC patients [25], [27], [29], [30], [34], [37], [42], [52], [57], [58], [78], [79], [81], 10 with non-IBD disease controls [25], [29], [30], [37], [52], [57], [58], [78], [79], [80], [81], and 8 with healthy controls [25], [27], [29], [30], [34], [42], [57], [58], [81].…”

The gut immune system, inflammatory bowel diseases, and the body immune homeostasis: modern treatment strategies

“…for example the combination ANCA+/ASCA-seem to indicate IBD against indeterminate colitis with a 82% predictive value [40].…”

Circulating Antibodies against Bacterial Wall Products: Are There Arguments for Early Immunosuppression?

“…ASCA is linked to CD and has been detected in the serum of approximately 60% of CD patients, 10% of UC patients, 15% of patients with other GI diseases and 5–10% of healthy controls [56,57,58,59,60,61,62,63]. The use of ASCA for the diagnosis and differentiation of IBD or CD has been tested extensively [63,64,65,66,67,68,69]. …”