Test ID: IBDP
Inflammatory Bowel Disease Serology Panel, Serum
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
As an adjunct in the diagnosis of ulcerative colitis and Crohns disease in patients suspected of having inflammatory bowel disease
Profile Information A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.
| 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 |
Method Name A short description of the method used to perform the test
AASCA/83022, GASCA/83023: Enzyme-Linked Immunosorbent Assay (ELISA)
NSA/82966: Indirect Immunofluorescent Assay (IFA)
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Crohn's Disease
IBD
Neutrophil Specific Ab
p-ANCA
Regional Enteritis
Ulcerative Colitis
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Specimen Volume: 0.5 mL
Forms: If not ordering electronically, submit a General Request Form (Supply T239) with the specimen.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild OK; Gross reject |
| Lipemia | Mild OK; Gross reject |
| Icterus | Mild OK; Gross OK |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 21 days |
| Frozen | 21 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
The term "inflammatory bowel disease" (IBD) is often used to refer to 2 diseases, ulcerative colitis (UC) and Crohn's disease (CD), that 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.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Saccharomyces cerevisiae ANTIBODY, IgA
Negative: 0.0-20.0 U
Equivocal: 20.1-24.9 U
Weakly positive: 25.0-34.9 U
Positive: > or =35.0 U
Saccharomyces cerevisiae ANTIBODY, IgG
Negative: 0.0-20.0 U
Equivocal: 20.1-24.9 U
Weakly positive: 25.0-34.9 U
Positive: > or =35.0 U
NEUTROPHIL-SPECIFIC ANTIBODIES
Negative (not detectable)
Interpretation Provides information to assist in interpretation of the test results
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's 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)
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Results from this test should not be exclusively relied upon to establish the diagnosis of ulcerative colitis (UC) or Crohn's disease (CD) or to distinguish between these 2 diseases. Some patients with CD have detectable neutrophil specific antibodies (NSA), and some patients with UC have elevated levels of IgA and/or IgG anti-Saccharomyces cerevisiae antibodies (ASCA).
Approximately one third of patients have low titered anti-nuclear antibodies (ANA), which make it impossible to distinguish the presence or absence of NSA. These results are reported as indeterminate.
Not useful to determine the extent of disease in patients with inflammatory bowel disease (IBD) or determine the response to disease-specific therapy including surgical resection of diseased intestine.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
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 Description Describes how the test is performed and provides a method-specific reference
IgG antibodies to Saccharomyces cerevisiae antigens (IgG ASCA) are measured by commercial, microtiter enzyme immunoassays (INOVA Diagnostics, San Diego, CA).(3) This assay uses polystyrene microtiter plates coated with partially purified Saccharomyces cerevisiae antigens to capture antibodies from patient's sera and horseradish peroxidase (HRP)-conjugated anti-IgG antibodies to detect IgG ASCA. Results of the test for IgG ASCA are reported in arbitrary units (U).(Package insert: QUANTA LITE ASCA [S. cerevisiae] IgG ELISA 708865)
Neutrophil specific antibodies (NSA) are detected qualitatively using an in-house developed method with a substrate of methanol-fixed, human neutrophils and fluorescein conjugated, anti-human IgG antibody as a detection protein. Results of the test for NSA are reported as positive, negative, or indeterminate.(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)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Varies
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
83520 x 2-Saccharomyces cerevisiae antibody, IgA and IgG
86255-Neutrophil-specific antibodies, inflammatory bowel disease
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| AASCA | Saccharomyces cerevisiae Ab, IgA, S | 47320-7 |
| GASCA | Saccharomyces cerevisiae Ab, IgG, S | 47321-5 |
| 82966 | Neutrophil Specific Antibodies | In Process |
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