Monday, 5 November 2007

New help to distinguish between Chrons Disease and Ulcerative Colitis in Children

Anti-glycan antibodies can help distinguish between Chrons disease and ulcerative colitis in children. This news was released at the United European Gastroenterology Week (UEGW) where researchers looked at the diagnostic relevance of serological anti-glycan antibodies in 110 young people less than 18 years old who had inflammatory bowel disease (IBD) and 630 people older than 18 years.

There has always been a problem in diagnosing people who either have chrons disease or ulcerative colitis as they are very similar and have many overlapping features, but the correct diagnosis is important for the correct form of treatment. Traditionally paediatric patients often have to endure invasive examination of combined upper endoscopy, colonoscopy, and terminal ileoscopy with biopsies and atthe end of this the exact disease (crohn's disease or ulcerative colitis) in up to 30% of patients is still unknown and they are defined as "indeterminate colitis" or unclassified inflammatory bowel disease.

In adult patients, anti-glycan antibodies IBDX has been found to help distinguish between Chrons disease and ulcerative colitis, so it is highly likely that IBDX markers may also help in the diagnosis of paediatric IBD patients. The hope is that this will reduce the use of invasive examination in young children.

During the tests, the diagnosis of IBD for each person was based upon standard endoscopic, histologic, and radiographic criteria and serological analysis of antibodies against mannan epitope of Saccharomyces cerevisiae (gASCA), laminaribioside (ALCA), chitobioside (ACCA), and mannobioside (AMCA) were performed using IBDX ELISA panel.

The Results
In the results of the tests, children with IBD, who tested positive for at least one of the markers could be identified as Chrons disease patients with a sensitivity of 65% and specificity of 84%; the positive and negative predictive values were 91% and 50%, respectively. Children who tested positive for 2 or more markers could be identified as Chrons disease with higher specificity (94%) but lower sensitivity (22%).

There were also no significant differences in the results between children and adults with IBD.

The Conclusion
So in conclusion these tests show for the first time that similar to adults, anti-glycan antibodies can distinguish between chrons disease and ulcerative colitis in children with IBD.

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