Clinical application of the multigene analysis test in discriminating between ulcerative colitis and Crohn's disease: a retrospective study.
METHODS
The newly described--multigene analysis test (DiBiCol) identifying 7 inflammatory bowel disease (IBD)-specific genes in colonic mucosal biopsy differentiating between ulcerative colitis (UC) and Crohn's disease (CD) with active inflammation--is a new addition to existing methods with a higher stated sensitivity and specificity. Method biopsy material from 78 patients with a complicated course diagnosed as most probably UC in 38, CD in 18 and inflammatory bowel disease unclassified (IBDU) in 22 were investigated by DiBiCol.


RESULTS
DiBiCol showed a pattern consistent with CD in 13 patients with UC and led to change of diagnosis in 3 patients and a strong suggestion of CD in 8 patients. A total of 2 patients remained as UC. DiBiCol showed a pattern of UC in 4 patients of 18 with CD leading to a changing of diagnosis to UC in 3 patients, but the fourth remained as CD. In 22 patients with IBDU DiBiCol showed a pattern consistent with UC in 7 cases and with CD in 13 cases. A new evaluation 1 year after the DiBiCol allowed the assessment of clinical diagnosis in 10 patients confirmed in 9 of 10 patients by DiBiCol. In patients with acute flare of colitis the clinical diagnosis corresponded in 10 of 12 UC and in 5 of 6 CD cases.


CONCLUSIONS
Adopting the DiBiCol test led to a change of the primary diagnosis in a significant number of patients with the initial diagnosis of UC and CD and suggested a clinically probable diagnosis in most of the patients with IBDU and in those with an acute flare of colitis.
Department of Clinical Sciences, Karolinska Institutet, Division of Internal Medicine Danderyd Hospital, Stockholm, Sweden. izabella.janczewska@ds.se
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I
Janczewska
M
M
Kapraali
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F
Saboonchi
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Q
Nekzada
Å
Å
Wessulv
J
J
Khoshkar
F
F
Marouf
J
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Gorsetman
D
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Risberg
M
M
Lissing
G
G
Wirström
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B
Sandstedt
D000328:Adult; D000368:Aged; D001706:Biopsy; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology*; D003424:Crohn Disease / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology*; D005260:Female; D005820:Genetic Testing; D005838:Genotype; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult