Crohn's Disease Differentiation Panel

The Crohn's Disease Differentiation Panel test contains 1 test with 5 biomarkers.

Test Description: Crohn's Disease Differentiation Panel

Purpose: The Crohn's Disease Differentiation Panel is a comprehensive serological test designed specifically to aid in the diagnosis and differentiation of Crohn’s Disease (CD), a subtype of Inflammatory Bowel Disease (IBD). This panel measures various antibodies associated with CD, helping clinicians to distinguish CD from other forms of IBD and gastrointestinal disorders.

Components:

Important Notice: Please be advised that this panel includes tests that may trigger reflexive testing. By ordering this panel, you acknowledge and consent to be charged for any additional tests that may be conducted based on reflex criteria, as detailed in the aforementioned fee schedule.
Potential Reflex Charges
C-ANCA TITER  $                   69 
P-ANCA TITER  $                   64 
ATYP P-ANCA TITER  $                   69 

Components:

  1. ANCA Screen with Reflex to ANCA Titer:

    • The test screens for anti-neutrophil cytoplasmic antibodies (ANCA), which are associated with autoimmune conditions including certain types of vasculitis and IBD. If the ANCA screen is positive, additional reflex testing to determine the specific ANCA titer (C-ANCA, P-ANCA, or atypical P-ANCA) will be automatically performed at an additional charge to aid in the interpretation and provide a comprehensive analysis.
  2. Myeloperoxidase Antibody (MPO):

    • MPO antibodies are part of the ANCA profile, commonly associated with P-ANCA. Their presence can be indicative of certain autoimmune conditions and vasculitides.
  3. Proteinase-3 Antibody:

    • Proteinase-3 antibodies are typically associated with C-ANCA and may be found in patients with Wegener’s Granulomatosis, a form of vasculitis.
  4. Saccharomyces cerevisiae Antibodies (ASCA) (IgG):

    • ASCA IgG antibodies are commonly found in patients with Crohn’s Disease and are used in differentiating CD from Ulcerative Colitis and other gastrointestinal disorders.
  5. Saccharomyces cerevisiae Antibodies (ASCA) (IgA):

    • ASCA IgA antibodies also play a role in distinguishing Crohn’s Disease from other forms of IBD and gastrointestinal conditions.

Reflex Testing:

  • If the ANCA screen is positive, reflex testing to ANCA titer will be performed at an additional charge (CPT code(s): 86037 for each titer performed). This reflex testing aids in the detailed characterization of the type of ANCA antibodies present and provides valuable information for a more accurate diagnosis.

Interpretation:

  • The presence of ASCA antibodies, particularly in high titers, is strongly associated with Crohn’s Disease.
  • Positive ANCA results, especially with a P-ANCA pattern, may also be observed in some patients with IBD, but are less specific for CD.
  • The results should be interpreted in conjunction with clinical findings, other laboratory tests, and imaging studies to ensure an accurate and comprehensive diagnosis.

Utility:

  • This panel is highly useful for clinicians in confirming a diagnosis of Crohn’s Disease and distinguishing it from other forms of IBD and gastrointestinal disorders.
  • It provides a targeted approach to diagnosing CD, allowing for timely and appropriate management and treatment strategies.

Limitations:

  • The test is not definitive on its own; a positive result for these antibodies can be found in other conditions and in healthy individuals.
  • Negative results do not rule out Crohn’s Disease, as seronegative cases are possible.
  • Further clinical correlation and additional diagnostic evaluation are required for a definitive diagnosis.

By providing a targeted and comprehensive assessment, the Crohn’s Disease Differentiation Panel plays a crucial role in the diagnostic process, aiding clinicians in making informed and accurate decisions for the management of patients with suspected Crohn’s Disease.

Methodology

Immunoassay (IA)

Reference Range(s)

 

ANCA Screen Negative
  P-ANCA Titer <1:20
  C-ANCA Titer <1:20
  Atypical P-ANCA Titer <1:20


Myeloperoxidase Antibody

<1.0 AI No antibody detected
≥1.0 AI Antibody detected


Proteinase-3 Antibody

<1.0 AI No antibody detected
≥1.0 AI Antibody detected


Saccharomyces cerevisiae Ab (IgG)

≤20.0 U Negative
20.1-29.9 U Equivocal
≥30.0 U Positive


Saccharomyces cerevisiae Ab (IgA)

≤20.0 U Negative
20.1-24.9 U Equivocal
≥25.0 U Positive

The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

Anca Screen

Myeloperoxidase Antibody

Antineutrophil cytoplasmic antibodies (ANCA) are a group of autoantibodies produced when a person's immune system mistakenly targets and attacks its own neutrophil proteins. Two of the most commonly targeted proteins are myeloperoxidase (MPO) and proteinase 3 (PR3). This results in the production of antibodies to MPO and/or PR3. The ANCA blood test detects the presence or absence of these autoantibodies. Antineutrophil cytoplasmic antibodies may be present in a variety of autoimmune disorders that cause inflammation and damage to blood vessels throughout the body (systemic vasculitis). Vasculitis can cause tissue and organ damage due to the narrowing and obstruction of blood vessels and the subsequent loss of blood supply. It can also produce areas of weakness in blood vessel walls, known as aneurysms, which have the potential to rupture.

Proteinase-3 Antibody

S Cerevisiae Ab (Iga)

S Cerevisiae Ab (IgG)

*Process times are an estimate and are not guaranteed. The lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.

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