IBD Expanded Panel (Inflammatory Bowel Disease)
A panel of serological markers that helps distinguish Crohn's disease from ulcerative colitis and flags Crohn's disease at higher risk of an aggressive course.
Inflammatory bowel disease (IBD) is a chronic disorder of the lower gastrointestinal tract. It takes three main forms — Crohn's disease (CD), ulcerative colitis (UC), and indeterminate colitis (IC) — and affects roughly 0.3% of adults. Telling one form from another is often difficult and time-consuming, and the diagnostic gold standard, endoscopy with biopsy, is invasive. Blood-based serological markers offer a less invasive way to support the differential diagnosis and to signal disease likely to behave aggressively.
The two long-established markers are anti-Saccharomyces cerevisiae antibodies (ASCA) and atypical perinuclear anti-neutrophil cytoplasmic antibodies (pANCA). ASCA are directed against a carbohydrate in the cell wall of baker's/brewer's yeast — a dietary and gut antigen rather than the body's own tissue — and are seen predominantly in Crohn's disease. pANCA is seen predominantly in ulcerative colitis. In combination, an ASCA-positive / pANCA-negative pattern can reach a specificity as high as ~99% for separating CD from UC, though a meaningful share of IBD patients are negative for both.
To improve sensitivity, this expanded profile pairs pANCA with four Crohn's-associated antibodies: gASCA (a glycan-based anti-yeast IgG), antilaminaribioside (ALCA, IgG), antichitobioside (ACCA, IgA), and antimannobioside (AMCA, IgG). Beyond diagnosis, these carry prognostic weight: in Crohn's disease, the more of these markers that are positive — and the higher their levels — the greater the association with small-bowel involvement and a complicated, aggressive disease course (strictures, fistulae, or need for surgery).
How results are interpreted:
| Result pattern | Suggested interpretation |
|---|---|
| Only pANCA positive | Ulcerative colitis |
| One of gASCA/ACCA/ALCA/AMCA positive, pANCA negative | Crohn's disease (risk not stratifiable) |
| One of gASCA/ACCA/ALCA/AMCA positive, pANCA positive | Inflammatory bowel disease, form not specified |
| Any two of the four positive (pANCA + or −) | Crohn's disease, high risk of aggressive behavior |
| Three or more of the four positive (pANCA + or −) | Crohn's disease, very high risk of aggressive behavior |
| All markers negative | Not suggestive of IBD |
Results should always be interpreted alongside clinical findings and other tests; a negative panel lowers the likelihood of aggressive disease but does not rule out future complications.
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Biomarkers included in this panel:
The IBD Expanded Panel test offers three novel markers: - antichitobioside IgA (ACCA), - antilaminaribioside IgG (ALCA), - antimannobioside IgG (AMCA), together with anti-Saccharomyces cerevisiae IgG (gASCA) and pANCA.
Learn moreThe IBD Expanded Panel test offers three novel markers: - antichitobioside IgA (ACCA), - antilaminaribioside IgG (ALCA), - antimannobioside IgG (AMCA), together with anti-Saccharomyces cerevisiae IgG (gASCA) and pANCA.
Learn moreThe IBD Expanded Panel test offers three novel markers: - antichitobioside IgA (ACCA), - antilaminaribioside IgG (ALCA), - antimannobioside IgG (AMCA), together with anti-Saccharomyces cerevisiae IgG (gASCA) and pANCA.
Learn moreAntigliadin IgG (native) is an antibody test that detects immune system reactivity to gliadin, a key protein found in gluten (wheat, barley, and rye). This test measures IgG antibodies, which are associated with delayed immune responses rather than t
Learn moreASCA IgA
Anti-Saccharomyces cerevisiae antibody (ASCA) IgA is an immune protein directed against a sugar in the cell wall of common yeast — not against your own tissue. It shows up far more often in people with Crohn's disease than in ulcerative col
Learn moreASCA IgG
Anti-Saccharomyces cerevisiae antibody (ASCA) IgG is an immune protein directed against a sugar in the cell wall of common yeast — not against your own tissue. It appears far more often in people with Crohn's disease than in ulcerative coli
Learn moreAtypical perinuclear antineutrophil cytoplasmic antibodies (p-ANCA) occur in most patients with ulcerative colitis but only in a minority of those with Crohn's disease.
Learn moreThis marker is usually part of a test called IBD Expanded Panel (IBD = Inflammatory Bowel Disease) and aids in the diagnosis of inflammatory bowel disease and the differential diagnosis of Crohn’s disease (CD) and ulcerative colitis (UC);
Learn moreAnti-Saccharomyces cerevisiae antibodies (ASCA) are immune proteins found in people with inflammatory bowel disease (IBD), which is a chronic condition characterized by swollen and damaged tissues in the intestinal tract. The ASCA test detects these
Learn moreAnti-Saccharomyces cerevisiae antibodies (ASCA) are immune proteins found in people with inflammatory bowel disease (IBD), which is a chronic condition characterized by swollen and damaged tissues in the intestinal tract. The ASCA test detects these
Learn more