Serological diagnosis of inflammatory bowel disease
How useful are these markers for the diagnosis of IBD? It has become clear that the combined measurement of both pANCA and ASCA yields the best diagnostic accuracy.8-10 The panel summarises the sensitivity and specificity of the combined assay. The combination of tests is not sensitive enough for it...
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| Published in: | The Lancet (British edition) 2000-12, Vol.356 (9248), p.2117-2118 |
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| Main Authors: | , |
| Format: | Article |
| Language: | eng |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | How useful are these markers for the diagnosis of IBD? It has become clear that the combined measurement of both pANCA and ASCA yields the best diagnostic accuracy.8-10 The panel summarises the sensitivity and specificity of the combined assay. The combination of tests is not sensitive enough for it to be used to investigate diarrhoeal illness generally. The high specificity suggests that the combined test may prove suitable for the differential diagnosis of IBD but in this setting too the value of this expensive diagnostic test remains to be proved. In most cases of IBD the diagnosis is straightforward and these tests will not replace endoscopic and radiological examinations. Preliminary evidence shows that the test combination may be useful in indeterminate colitis.11 ASCA positivity in such patients might be a strong predictor of evolution to [Crohn]'s disease whereas positivity for pANCA might indicate likely progression to ulcerative colitis or to ulcerative-colitis-like Crohn's disease. pANCA may also predict severe pouchitis after restorative proctocolectomy in ulcerative colitis. |
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| ISSN: | 0140-6736 1474-547X |