Annual Meeting of the North American Society for Pediatric Gastroenterology and Nutrition; Orlando, October 22-24, 1998
SEROLOGICAL MARKERS IN COMBINATION WITH NON-INVASIVE LABORATORY TESTS DISCRIMINATE BETWEEN IBD AND IRRITABLE BOWEL IN CHILDREN
We and other have found that antibodies against Saccharomyces cervisiae (ASCA) and pANCA are highly specific for Crohn's disease (CD) and ulcerative colitis (UC), respectively. AIM: To prospectively evaluate the predictive value of ASCA and pANCA, in combination with other non-invasive laboratory tests (described below), in screening for IBD in children. METHODS: Serum was collected from 50 consecutive patients referred for assessment of possible IBD. All patients were classified as CD, UC or non-IBD controls on the basis of clinical, radiological endoscopic and histological criteria (including: UGI/SBFT, complete colonoscopy and biopsies). The presence of ASCA and pANCA was determined blinded to clinical diagnosis (Prometheus Laboratory, San Diego, CA). Routine blood tests (hemoglobin, ESR, serum iron and albumin) were performed concurrently. (Table) A significant (χ2 p<0.001) difference was observed between the IBD and non-IBD controls for the number of patients with a) ≥1 abnormal lab test (27/28 vs 10/22) and b) positive serology (18/28 vs 0/22). Among the sub-group of patients with an irritable bowel syndrome (IBS), 92% had a completely negative combination of tests, compared to 0% of patients with IBD. CONCLUSION: ASCA and pANCA, in combination with other non-invasive laboratory tests, clearly distinguish between IBD and IBS in the absence of invasive testing. Inflammatory control and IBD patients have a similar incidence of abnormal lab tests, yet highly specific ASCA and pANCA tests can assist the clinician in discriminating between these two groups.
Abdominal Pain/IBD/Outcomes© 1998 Lippincott Williams & Wilkins, Inc.