Combined Use of Noninvasive Tests is Useful in the Initial Diagnostic Approach to a Child with Suspected Inflammatory Bowel Disease

Autor: Vincenzo Bisesti, Riccardo Troncone, Gianfranco Vallone, Roberto Berni Canani, Erasmo Miele, L. Rapacciuolo, G. Polito, Gianluca Terrin, Sodano A, Laura Tanturri de Horatio, M. T. Romano, Francesco Manguso, Annamaria Staiano
Přispěvatelé: BERNI CANANI, Roberto, de Horatio, Lt, Terrin, G, Romano, Mt, Miele, Erasmo, Staiano, Annamaria, Rapacciuolo, L, Polito, G, Bisesti, V, Manguso, F, Vallone, Gianfranco, Sodano, A, Troncone, Riccardo
Rok vydání: 2006
Předmět:
Male
Antineutrophil Cytoplasmic
asca
crohn disease
fecal calprotectin
intestinal permeability
panca
small bowel ultrasonography
ulcerative colitis
Familial Mediterranean fever
Ulcerative
Small
Inflammatory bowel disease
Gastroenterology
Feces
Fecal calprotectin
Crohn Disease
Diagnosis
Intestine
Small
Child
ASCA
Crohn disease
Intestinal permeability
pANCA
Small bowel ultrasonography
Ulcerative colitis
Adolescent
Antibodies
Antineutrophil Cytoplasmic
Antibodies
Fungal
Colitis
Ulcerative
Diagnosis
Differential
Diagnostic Tests
Routine
Female
Humans
Inflammatory Bowel Diseases
Leukocyte L1 Antigen Complex
Permeability
Reproducibility of Results
Saccharomyces cerevisiae
Sensitivity and Specificity
Ultrasonography
biology
medicine.diagnostic_test
Panca
Colitis
Intestine
Fungal
medicine.symptom
medicine.medical_specialty
Infectious Enterocolitis
Antibodies
Diagnostic Tests
Internal medicine
Biopsy
medicine
Routine
business.industry
medicine.disease
biology.organism_classification
digestive system diseases
Hematochezia
Differential
Pediatrics
Perinatology and Child Health
Calprotectin
business
Zdroj: Journal of Pediatric Gastroenterology and Nutrition. 42:9-15
ISSN: 0277-2116
DOI: 10.1097/01.mpg.0000187818.76954.9a
Popis: Objective To assess the effectiveness of the combined use of fecal calprotectin (FC), anti-Saccharomyces cerevisiae antibody (ASCA), perinuclear staining antineutrophil antibody (pANCA), small intestinal permeability test (IP), and bowel wall ultrasonography measurement (BWUS) in the diagnostic work-up of children with suspected inflammatory bowel disease (IBD). Methods All children referred for initial assessment of possible IBD were eligible. Patients with symptoms or signs (right-lower quadrant mass, perianal disease, or hematochezia) mandating a complete work-up for IBD were excluded. All enrolled patients underwent a clinical, laboratory, radiographic, and endoscopic evaluation including biopsy examinations. The immunoglobulin (Ig)G and IgA ASCA, IgG pANCA, FC, IP, and BWUS were tested in all patients at the initial assessment. Results A final diagnosis of IBD was made in 27 patients: 17 Crohn disease and 10 ulcerative colitis. Eighteen children had other gastrointestinal diagnoses (8 functional bowel disorders, 5 food allergy-mediated diseases, 4 infectious enterocolitis, 1 familial Mediterranean fever). In patients with simultaneous abnormal values of FC, BWUS, and ASCA/pANCA, the estimated probability of having IBD was 99.47%. Patients with negative results on all tests had a 0.69% of probability of IBD. Conclusions The incorporation of noninvasive diagnostic tests into the initial diagnostic approach may avoid unnecessary invasive procedures and facilitate clinical decision-making when the diagnosis of IBD in children is initially uncertain.
Databáze: OpenAIRE
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