IBD Expanded Panel (Inflammatory Bowel Disease)

Five-marker IBD profile identifies and differentiates patients with ulcerative colitis (UC) and Crohn’s disease (CD).

Novel serological markers for inflammatory bowel disease (IBD) improve sensitivity and specificity to aid in differential diagnosis and provide valuable prognostic information about disease behavior.

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) 
- 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.

Five-marker Profile Ulcerative Colitis Crohn’s Disease Crohn’s with High Risk of Aggressive Disease Crohn’s with Very High Risk of Aggressive Disease
pANCA Positive (+) Up to 70% sensitivity Negative (-) Negative (-) or positive (+) Negative (-) or positive (+)
gASCA IgG Negative (-) Positive (+) 66.1% sensitivity

Two positive (+) markers

High risk

Three or more positive (+) markers

Very high risk

ALCA IgG Negative (-) Positive (+) 85.5% sensitivity
ACCA IgA
AMCA IgG

 

ACCA

Optimal range: 0 - 80 Units

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.

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ALCA

Optimal range: 0 - 55 Units

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.

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AMCA

Optimal range: 0 - 90 Units

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.

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Atypical pANCA

Optimal range: 0 - 0 Units

Atypical perinuclear antineutrophil cytoplasmic antibodies (p-ANCA) occur in most patients with ulcerative colitis but only in a minority of those with Crohn's disease.

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gASCA

Optimal range: 0 - 45 Units

This 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); it is also a prognostic aid for clinical management of patients with CD.

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