Test Id : IBDP2
Inflammatory Bowel Disease Serology Panel, Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
Distinguishing between ulcerative colitis and Crohn disease in patients for whom the specific diagnosis is unclear based on endoscopic, pathologic, and imaging evaluations
This test is not useful for determining the extent of disease in patients with inflammatory bowel disease or determining the response to disease-specific therapy including surgical resection of diseased intestine.
Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ANCA2 | Cytoplasmic Neutrophilic Ab IBD, S | No | Yes |
| SCERA | Saccharomyces cerevisiae Ab, IgA, S | Yes | Yes |
| SCERG | Saccharomyces cerevisiae Ab, IgG, S | Yes | Yes |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For more information see Inflammatory Bowel Disease Diagnostic Testing Algorithm.
For more information see Ulcerative Colitis and Crohn Disease Therapeutic Drug Monitoring Algorithm.
Method Name
A short description of the method used to perform the test
SCERA, SCERG: Enzyme-Linked Immunosorbent Assay (ELISA)
ANCA2: Indirect Immunofluorescent Assay (IFA)
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
ASCA (Saccharomyces cerevisiae Antibody)
Crohn's Disease
IBD
Neutrophil Specific Ab
p-ANCA
Regional Enteritis
Ulcerative Colitis
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For more information see Inflammatory Bowel Disease Diagnostic Testing Algorithm.
For more information see Ulcerative Colitis and Crohn Disease Therapeutic Drug Monitoring Algorithm.
Specimen Type
Describes the specimen type validated for testing
Serum
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
Forms
If not ordering electronically, complete, print, and send Gastroenterology and Hepatology Test Request (T728) with the specimen.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
0.8 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | OK |
| Heat-treated specimen | Reject |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 21 days | |
| Frozen | 21 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Distinguishing between ulcerative colitis and Crohn disease in patients for whom the specific diagnosis is unclear based on endoscopic, pathologic, and imaging evaluations
This test is not useful for determining the extent of disease in patients with inflammatory bowel disease or determining the response to disease-specific therapy including surgical resection of diseased intestine.
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For more information see Inflammatory Bowel Disease Diagnostic Testing Algorithm.
For more information see Ulcerative Colitis and Crohn Disease Therapeutic Drug Monitoring Algorithm.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Inflammatory bowel disease (IBD) refers to 2 diseases - ulcerative colitis (UC) and Crohn disease (CD), both of which result from chronic inflammation in the gastrointestinal (GI) tract.(1) CD is characterized by chronic diarrhea, abdominal pain, and fatigue.(2) In comparison, UC frequently presents with bloody diarrhea that is of an urgent nature.(3) Inflammation in UC most frequently affects the rectum and proximal colon, and presents with continue mucosal involvement. In CD, inflammation can affect almost any area of the GI tract and is usually evidenced as patchy, transmural lesions.
Diagnosis of IBD is primarily based on clinical evaluation, endoscopy with biopsy, and imaging studies.(4) Because CD and UC are characterized by GI inflammation, fecal calprotectin can be used to differentiate IBD from noninflammatory conditions such as irritable bowel syndrome (IBS). Fecal calprotectin is useful in excluding IBD as a diagnosis and avoiding unnecessary endoscopic or imaging procedures.
CD and UC are associated with the presence of various antimicrobial and autoantibodies.(5) Patients with UC often have measurable antineutrophil cytoplasmic antibodies (ANCA), which react with as yet uncharacterized target antigens in human neutrophils; in contrast, patients with CD often have measurable IgA and/or IgG antibodies, which react with cell wall mannan of Saccharomyces cerevisiae. Despite these associations, current guidelines indicate that testing for these antibodies is not sufficiently sensitive for use in the diagnosis of IBD.(2,3) Rather, these antibodies should be limited to distinguishing between CD and UC in cases where the specific diagnosis is unclear based on pathologic and imaging studies.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Saccharomyces cerevisiae ANTIBODY, IgA
Negative: <20.0 RU/mL
Positive: > or =20.0 RU/mL
Saccharomyces cerevisiae ANTIBODY, IgG
Negative: <20.0 RU/mL
Positive: > or =20.0 RU/mL
CYTOPLASMIC NEUTROPHIL ANTIBODIES, INFLAMMATORY BOWEL DISEASE PANEL, SERUM
Negative (not detectable)
Interpretation
Provides information to assist in interpretation of the test results
The presence of antineutrophil cytoplasmic antibodies in the absence of IgA and IgG anti-Saccharomyces cerevisiae antibodies is consistent with the diagnosis of ulcerative colitis; the presence of IgA and IgG ASCA in the absence of ANCA is consistent with Crohn disease.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Results from this test should not be exclusively relied upon to establish the diagnosis of ulcerative colitis (UC) or Crohn disease (CD) or to distinguish between these 2 diseases.
Some patients with CD have detectable antineutrophil cytoplasmic antibodies (ANCA), and some patients with UC have detectable IgA and/or IgG anti-Saccharomyces cerevisiae antibodies (ASCA). Some patients with UC or CD do not have detectable ANCA, IgA ASCA, or IgG ASCA.
ANCA results may be reported as indeterminate if interfering antinuclear antibodies (ANA) are present.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Rose NR, Mackay IR, eds: Inflammatory bowel diseases. In: The Autoimmune Diseases. Elsevier; 2008
2. Lichtenstein GR, Loftus EV, Isaacs KL, et al. ACG clinical guideline: Management of crohn's disease in adults. Am J Gastroenterol. 2018;113(4):481-517
3. Rubin DT, Ananthakrishnan AN, Siegel CA, et al. ACG clinical guideline: Ulcerative colitis in adults. Am J Gastroenterol. 2019;114(3):384-413
4. Clark C, Turner J. Diagnostic modalities for inflammatory bowel disease: Serologic markers and endoscopy. Surg Clin North Am. 2015;95(6):1123-1141
5. Zhou G, Song Y, Yang W, et al. ASCA, ANCA, ALCA and many more: Are they useful in the diagnosis of inflammatory bowel disease? Dig Dis. 2016;34:90-97
Method Description
Describes how the test is performed and provides a method-specific reference
IgA or IgG antibodies to Saccharomyces cerevisiae antigens (ASCA) are measured by commercial, microtiter enzyme immunoassays. These assays use polystyrene microtiter plates coated with purified mannan from the cell wall of S cerevisiae to capture antibodies from patient sera, and horseradish peroxidase-conjugated anti-IgA or anti-IgG antibodies to detect ASCA. Results of the tests for ASCA are reported in relative units per milliliter (RU/mL).(Package inserts: Anti-Saccharomyces cerevisiae ELISA (IgA), 5/2011; Anti-Saccharomyces cerevisiae ELISA (IgG), EUROIMMUN Medizinische Labordiagnostika AG; 5/2011)
Antineutrophil cytoplasmic antibodies (ANCA) are detected qualitatively using an in-house developed method with a substrate of ethanol-fixed, human neutrophils and fluorescein conjugated, antihuman IgG antibody as a detection protein. Results of the test for ANCA are reported as positive, negative, or indeterminate.(Unpublished Mayo method)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Friday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
86671 x 2
86036
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| IBDP2 | Inflammatory Bowel Disease Panel, S | 87551-8 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| 610030 | Cytoplasmic Neutrophilic Ab IBD, S | 17355-9 |
| 614542 | ANCA2 Interpretation | 49308-0 |
| SCERA | Saccharomyces cerevisiae Ab, IgA, S | 47320-7 |
| SCERG | Saccharomyces cerevisiae Ab, IgG, S | 47321-5 |