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. © 2006 Lippincott Williams & Wilkins.

Combined use of noninvasive tests is useful in the initial diagnostic approach to a child with suspected inflammatory bowel disease / Roberto Berni, Canani; L. T., De Horatio; Terrin, Gianluca; Maria Teresa, Romano; Erasmo, Miele; Annamaria, Staiano; Luciano, Rapacciuolo; Gaetano, Polito; Vincenzo, Bisesti; Francesco, Manguso; Gianfranco, Vallone; Antonio, Sodano; Riccardo, Troncone. - In: JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION. - ISSN 0277-2116. - 42:1(2006), pp. 9-15. [10.1097/01.mpg.0000187818.76954.9a]

Combined use of noninvasive tests is useful in the initial diagnostic approach to a child with suspected inflammatory bowel disease

TERRIN, GIANLUCA;
2006

Abstract

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. © 2006 Lippincott Williams & Wilkins.
2006
asca; crohn disease; fecal calprotectin; intestinal permeability; panca; small bowel ultrasonography; ulcerative colitis
01 Pubblicazione su rivista::01a Articolo in rivista
Combined use of noninvasive tests is useful in the initial diagnostic approach to a child with suspected inflammatory bowel disease / Roberto Berni, Canani; L. T., De Horatio; Terrin, Gianluca; Maria Teresa, Romano; Erasmo, Miele; Annamaria, Staiano; Luciano, Rapacciuolo; Gaetano, Polito; Vincenzo, Bisesti; Francesco, Manguso; Gianfranco, Vallone; Antonio, Sodano; Riccardo, Troncone. - In: JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION. - ISSN 0277-2116. - 42:1(2006), pp. 9-15. [10.1097/01.mpg.0000187818.76954.9a]
File allegati a questo prodotto
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/402546
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? 20
  • Scopus 107
  • ???jsp.display-item.citation.isi??? 93
social impact