Characteristics of Inflammatory Bowel Disease Serology in Patients With Indeterminate Colitis

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Characteristics of Inflammatory Bowel Disease Serology in Patients With Indeterminate Colitis

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Title: Characteristics of Inflammatory Bowel Disease Serology in Patients With Indeterminate Colitis
Author: Sura, Siddharth P.; Ahmed, Awais; Cheifetz, Adam S.; Moss, Alan C

Note: Order does not necessarily reflect citation order of authors.

Citation: Sura, Siddharth P., Awais Ahmed, Adam S. Cheifetz, and Alan C. Moss. 2014. “Characteristics of Inflammatory Bowel Disease Serology in Patients With Indeterminate Colitis.” Journal of Clinical Gastroenterology 48 (4) (April): 351–355. doi:10.1097/mcg.0000000000000083.
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Abstract: Goals and Background

Inflammatory bowel disease (IBD) serology testing is often used in patients with indeterminate colitis (IC) to help distinguish between ulcerative colitis (UC) and Crohn’s disease (CD). We investigated the performance of serology testing in predicting future diagnosis in this setting.

Study

Observational study of individuals with IC at a single center who underwent IBD serology testing (pANCA, ASCA and anti-OmpC) and had at least 12 months follow-up from time of serology result.

Results

117 individuals with IC and 1 year follow-up data were enrolled. All IC patients had endoscopic and histologic evidence of colitis at enrollment. One year after serology testing, 58 (50%) individuals with IC were diagnosed with UC, 49 (42%) with CD, and 10 (9%) remained labeled with IC. The sensitivity/specificity of an initial positive pANCA for a subsequent diagnosis of UC was 78%/44%. For ASCA and anti-OmpC, the results were 18%/84% and 27%/75%, respectively, for a subsequent diagnosis of CD. A positive pANCA test was associated with a likelihood ratio (LR) of 1.4 (95% CI: 1.1–1.8) for a subsequent diagnosis of UC at 1 year. Neither positive ASCA (LR 1.1; 95% CI: 0.5–2.5) nor anti-OmpC (LR 1.1; 95% CI: 0.6–2.0) was associated with a subsequent diagnosis CD in patients with IC.

Conclusions

The disease phenotype in the majority of individuals initially labeled with IC evolved to be more consistent with either UC or CD on follow-up. pANCA, ASCA, and anti-OmpC, individually, were of limited utility in predicting a patient’s subsequent disease phenotype.
Published Version: 10.1097/MCG.0000000000000083
Other Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3956001/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:33942643
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