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Test Code 2507 Inflammatory Bowel Disease Serology Panel, Serum

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum


Specimen Required


Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 1 mL


Specimen Minimum Volume

0.8 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 21 days
  Frozen  21 days

Reference Values

Saccharomyces cerevisiae ANTIBODY, IgA

Negative: ≤20.0 U

Equivocal: 20.1-24.9 U

Weakly positive: 25.0-34.9 U

Positive: ≥35.0 U

 

Saccharomyces cerevisiae ANTIBODY, IgG

Negative: ≤20.0 U

Equivocal: 20.1-24.9 U

Weakly positive: 25.0-34.9 U

Positive: ≥35.0 U

 

NEUTROPHIL-SPECIFIC ANTIBODIES

Negative (not detectable)

Day(s) and Time(s) Performed

Varies

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

86255

86671 x 2

LOINC Code Information

Test ID Test Order Name Order LOINC Value
IBDP Inflammatory Bowel Disease Panel, S 87551-8

 

Result ID Test Result Name Result LOINC Value
AASCA Saccharomyces cerevisiae Ab, IgA, S 47320-7
GASCA Saccharomyces cerevisiae Ab, IgG, S 47321-5
82966 Neutrophil Specific Antibodies 17355-9

Clinical Information

Inflammatory bowel disease (IBD) refers to 2 diseases, ulcerative colitis (UC) and Crohn disease (CD), which produce inflammation of the large or small intestines. The diagnosis of these 2 diseases is based on clinical features, the results of barium X-rays, colonoscopy, mucosal biopsy histology, and in some cases operative findings and resected bowel pathology and histology.

 

Recently, patients with IBD have been shown to have antibodies in serum that help to distinguish between CD and UC.(1) Patients with UC often have measurable neutrophil-specific antibodies (NSA), which react with as yet uncharacterized target antigens in human neutrophils; whereas, patients with CD often have measurable antibodies of the IgA and/or IgG isotypes, which react with cell wall mannan of Saccharomyces cerevisiae strain Su 1.

Interpretation

The finding of neutrophil specific antibodies (NSA) with normal levels of IgA and IgG anti-Saccharomyces cerevisiae antibodies (ASCA) is consistent with the diagnosis of ulcerative colitis (UC); the finding of negative NSA with elevated IgA and IgG ASCA is consistent with Crohn disease (CD).

 

NSA are detectable in approximately 50% of patients with UC, and elevated levels of either IgA or IgG ASCA occur in approximately 55% of patients with CD. Approximately 40% of patients with CD have elevated levels of both IgA and IgG ASCA.

 

Employed together, the tests for NSA and ASCA have the following positive predictive values (PV) for UC and CD, respectively: NSA positive with normal levels of IgA and IgG ASCA, PV of 91%; NSA negative with elevated levels if IgA and IgG ASCA, PV of 90%.(2)

Clinical Reference

1. Sandborn WJ, Loftus EV Jr, Homburger HA, et al: Evaluation of serological disease markers in a population-based cohort of patients with ulcerative colitis and Crohn's disease. Inflamm Bowel Dis 2001 Aug;7(3):192-201

2. Homburger HA, Unpublished Mayo information

3. Vidrich A, Lee J, Janes E: Segregation of pANCA antigenic recognition by DNase treatment of neutrophils: ulcerative colitis, type 1 autoimmune hepatitis, and primary sclerosing cholangitis. J Clin Immunol 1995;Nov15(6):293-299

Method Name

AASCA, GASCA: Enzyme-Linked Immunosorbent Assay (ELISA)

NSA: Indirect Immunofluorescent Assay (IFA)

Profile Information

Test ID Reporting Name Available Separately Always Performed
AASCA Saccharomyces cerevisiae Ab, IgA, S Yes Yes
GASCA Saccharomyces cerevisiae Ab, IgG, S Yes Yes
NSA Neutrophil Specific Antibodies No Yes

Forms

If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Client Test Request (T728) with the specimen.