Crohn's Disease Prognostic Profile

CPT: 83516(x3); 86671
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Test Details

Synonyms

  • Glycominds
  • IBDX

Test Includes

Antichitobioside carbohydrate antibodies (ACCA); antilaminaribioside carbohydrate antibodies (ALCA); antimannobioside carbohydrate antibodies (AMCA); anti-Saccharomyces cerevisiae antibodies (ASCA)

Use

Prognostic aid for use in the clinical management of patients who have been diagnosed with Crohn's disease.

Limitations

The absence of antibody reactivity in this panel, although associated with increased incidence of a more benign course, does not preclude the future development of more complicated disease or need for surgery.1

Methodology

Enzyme immunoassay (EIA)

Additional Information

The presence and increasing titer of these antibodies has been shown to correlate with a more complicated disease course (strictures or fistulas) or the need for surgery. The antibodies included in the panel are ASCA (anti-Saccharomyces cerevisiae antibodies), ALCA (antilaminaribioside carbohydrate antibodies), ACCA (antichitobioside carbohydrate antibodies), and AMCA (antimannobioside carbohydrate antibodies).1-3 Numerous studies of CD have demonstrated an association between ileal disease and the presence of ASCA,1-7 ACCA,1 ALCA,1,3 and AMCA.3 Among these antibodies, the association with localization to the small intestine increased with the number of positive antibodies and with the concentration of individual antibodies.1-3,6,8 A more aggressive or complicated disease course in CD (as indicated by stricturing or perforation of the intestine or need of surgery), has also been associated with the presence of ASCA,1-3,5,7 ALCA,1-3 ACCA,1,2 and AMCA.1,2 Among these antibodies, the association with complicated disease behavior or surgery increased with the number and concentration of antibodies.1,2,6,8

Specimen Requirements

Specimen

Serum

Volume

1 mL

Minimum Volume

0.2 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Refrigerate

Causes for Rejection

Hemolysis; lipemia; heat-treated specimen; gross bacterial contamination

Clinical Information

Footnotes

1. Ferrante M, Henckaerts L, Joossens M, et al. New serological markers in inflammatory bowel disease are associated with complicated disease behavior. Gut. 2007 Oct; 56(10):1394-1403. 17456509
2. Papp M, Altorjay I, Dotan N, et al. New serological markers for inflammatory bowel disease are associated with earlier age at onset, complicated disease behavior, risk for surgery, and NOD2/CARD15 genotype in a Hungarian IBD cohort. Am J Gastroenterol. 2008 Mar; 103(3):665-681. 18047543
3. Dotan I, Fishman S, Dgani Y, et al. Antibodies against laminaribioside and chitobioside are novel serologic markers in Crohn's disease. Gastroenterology. 2006 Aug; 131(2):366-378. 16890590
4. Vasiliauskas EA, Plevy SE, Landers CJ, et al. Perinuclear antineutrophil cytoplasmic antibodies in patients with Crohn's disease define a clinical subgroup. Gastroenterology. 1996 Jun; 110(6):1810-1819. 8964407
5. Vasiliauskas EA, Kam LY, Karp LC, Gaiennie J, Yang H, Targan SR. Marker antibody expression stratifies Crohn's disease into immunologically homogeneous subgroups with distinct clinical characteristics. Gut. 2000 Oct; 47(4):487-496. 10986208
6. Arnott ID, Landers CJ, Nimmo EJ, et al. Sero-reactivity to microbial components in Crohn's disease is associated with disease severity and progression, but not NOD2/CARD15 genotype. Am J Gastroenterol. 2004 Dec; 99(12):2376-2384. 15571586
7. Walker LJ, Aldhous MC, Drummond HE, et al. Anti-Saccharomyces cerevisiae antibodies (ASCA) in Crohn's disease are associated with disease severity but not NOD2/CARD15 mutations. Clin Exp Immunol. 2004 Mar; 135(3):490-496. 15008984
8. Mow WS, Vasiliauskas EA, Lin YC, et al. Association of antibody responses to microbial antigens and complications of small bowel Crohn's disease. Gastroenterology. 2004 Feb; 126(2):414-424. 14762777

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
162020 Crohn's IBDX Prognostic Panel 53598-9 162021 gASCA units 47321-5
162020 Crohn's IBDX Prognostic Panel 53598-9 162022 ACCA units 53594-8
162020 Crohn's IBDX Prognostic Panel 53598-9 162023 ALCA units 53596-3
162020 Crohn's IBDX Prognostic Panel 53598-9 162025 AMCA units 53597-1

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