Inflammatory Bowel Disease (IBD) Differentiation Panel

The Inflammatory Bowel Disease (IBD) Differentiation Panel test contains 1 test with 5 biomarkers.

Inflammatory Bowel Disease Differentiation Panel

Test Description: Inflammatory Bowel Disease Differentiation Panel

Purpose: The Inflammatory Bowel Disease (IBD) Differentiation Panel is designed to aid in the differentiation of IBD, primarily distinguishing between Crohn’s Disease (CD) and Ulcerative Colitis (UC), as well as to rule out other potential causes of gastrointestinal symptoms. This comprehensive panel includes various serological tests that measure specific antibodies which are often associated with IBD.

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:

    • This test screens for the presence of anti-neutrophil cytoplasmic antibodies (ANCA), which are associated with various vasculitides and IBD. If the ANCA screen is positive, reflex testing to determine the ANCA titer (either C-ANCA, P-ANCA, or atypical P-ANCA) will be automatically performed at an additional charge to quantify the level of antibodies and aid in the interpretation of the results.
  2. Myeloperoxidase Antibody (MPO):

    • MPO antibodies are often detected in patients with vasculitis and are part of the ANCA profile. They are associated with P-ANCA positivity.
  3. Proteinase-3 Antibody:

    • Proteinase-3 antibodies are typically associated with C-ANCA positivity and can 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 to differentiate it from Ulcerative Colitis.
  5. Saccharomyces cerevisiae Antibodies (ASCA) (IgA):

    • Similar to ASCA IgG, ASCA IgA antibodies are used to differentiate Crohn’s Disease from Ulcerative Colitis.

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). The reflex testing helps to further characterize the type of ANCA present and assists in the diagnostic evaluation.

Interpretation:

  • Positive results for ANCA and/or ASCA may support a diagnosis of IBD, but must be interpreted in conjunction with clinical findings, other laboratory tests, and imaging studies.
  • A positive ANCA test, particularly with a C-ANCA pattern, may also be associated with other autoimmune conditions, including vasculitis.
  • The presence of ASCA antibodies, particularly in higher titers, is more commonly associated with Crohn’s Disease.

Utility:

  • This panel is useful for clinicians in the differentiation of IBD, aiding in diagnostic clarity and guiding appropriate treatment strategies.
  • It is particularly helpful in complex cases where the clinical presentation is ambiguous and additional laboratory data is needed for a comprehensive evaluation.

Limitations:

  • The presence of these antibodies alone is not diagnostic of IBD or any specific subtype of IBD.
  • Seronegative cases of IBD are possible, and a negative result does not rule out the disease.
  • Additional clinical correlation and further diagnostic evaluation are required for a definitive diagnosis.

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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