Author(s): Schoepfer AM, Trummler M, Seeholzer P, SeiboldSchmid B, Seibold F
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Abstract BACKGROUND: Symptoms of inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) can overlap. We aimed to determine the accuracy of fecal markers, C-reactive protein (CRP), blood leukocytes, and antibody panels for discriminating IBD from IBS and to define a "best test." METHODS: We prospectively included 64 patients with IBD (36 Crohn's disease [CD], 28 ulcerative colitis [UC]), 30 with IBS, and 42 healthy controls. Besides CRP and blood leukocytes, blinded fecal samples were measured for calprotectin (PhiCal Test, enzyme-linked immunosorbent assay [ELISA]), lactoferrin (IBD-SCAN, ELISA), Hexagon-OBTI (immunochromatographic test for detection of human hemoglobin), and LEUKO-TEST (lactoferrin latex-agglutination test). Blinded serum samples were measured for the antibodies ASCA (ELISA) and pANCA (immunofluorescence). RESULTS: Overall accuracy of tests for discriminating IBD from IBS: IBD-SCAN 90\%, PhiCal Test 89\%, LEUKO-TEST 78\%, Hexagon-OBTI 74\%, CRP 73\%, blood leukocytes 63\%, CD antibodies (ASCA+/pANCA- or ASCA+/pANCA+) 55\%, UC antibodies (pANCA+/ASCA-) 49\%. ASCA and pANCA had an accuracy of 78\% for detecting CD and 75\% for detecting UC, respectively. The overall accuracy of IBD-SCAN and PhiCal Test combined with ASCA/pANCA for discriminating IBD from IBS was 92\% and 91\%, respectively. CONCLUSIONS: The PhiCal Test and IBD-SCAN are highly accurate for discriminating IBD from IBS. There is only marginal additional diagnostic accuracy when the PhiCal Test and IBD-SCAN are combined with ASCA and pANCA. ASCA and pANCA have a high specificity for IBD.
This article was published in Inflamm Bowel Dis
and referenced in Journal of Molecular Biomarkers & Diagnosis