title: Diagnostic value of serological assays in pediatric inflammatory bowel disorders.
abstract: BACKGROUND
  Pediatric studies reported that the combined use of the anti-neutrophil cytoplasm autoantibodies (ANCA) and the anti-Saccharomyces cerevisiae mannan antibodies (ASCA) may be a specific useful noninvasive test in the diagnosis of inflammatory bowel diseases (IBD).
  
  
  OBJECTIVE
  To evaluate the diagnostic accuracy of ANCA and ASCA in children with suspected IBD, and to see whether different commercially available assays (indirect immunofluorescence vs. ELISA) agree well enough in terms of analytical performance.
  
  
  METHODS
  Sixty-nine children (30 males, 39 females, age range 2-18 years) with suspicion of IBD entered the study. Before colonoscopy, a blood sample was also drawn to assess ASCA and ANCA.
  
  
  RESULTS
  A diagnosis of IBD was established in 47 patients; the remainder had infective or other causes of colitis. For ulcerative colitis, the association ASCA-/ANCA+ had 70% sensitivity and 86% specificity, with a positive predictive value of 82%. The association ASCA+/ANCA- had 86% sensitivity and 93% specificity for Crohn's disease, with a positive predictive value of 75%.
  
  
  CONCLUSIONS
  Although more experience is needed to state the diagnostic power of serologic assay, determination of ANCA and ASCA in IBD children may help both in distinguish these conditions from other entities and ulcerative colitis from Crohn's disease, particularly in doubtful cases.
authors.affiliation: Department of Clinical Pathology, Ospedale Maggiore, Crema, Italy.
authors.forename: Elsa
authors.initials: E
authors.lastname: Mainardi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Villanacci
authors.forename: Gabrio
authors.initials: G
authors.lastname: Bassotti
authors.forename: Barbara
authors.initials: B
authors.lastname: Liserre
authors.forename: Elisa
authors.initials: E
authors.lastname: Rossi
authors.forename: Paolo
authors.initials: P
authors.lastname: Incardona
authors.forename: Diego
authors.initials: D
authors.lastname: Falchetti
authors.forename: Luca
authors.initials: L
authors.lastname: Tonegatti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Montanelli
authors.forename: Arrigo
authors.initials: A
authors.lastname: Barabino
authors.forename: Cristina
authors.initials: C
authors.lastname: Coccia
authors.forename: Claudio
authors.initials: C
authors.lastname: Gambini
mesh_terms: D000293:Adolescent; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D000908:Antibodies, Fungal / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003113:Colonoscopy; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007223:Infant; D015212:Inflammatory Bowel Diseases / Q000097:blood* / Q000175:diagnosis*; D008297:Male; D011237:Predictive Value of Tests; D012441:Saccharomyces cerevisiae / Q000276:immunology; D012680:Sensitivity and Specificity
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D000908:Antibodies, Fungal; D015415:Biomarkers