Serologic testing in inflammatory bowel disease: Its value in indeterminate colitis

Abstract Background Inflammatory bowel disease (IBD) is a debilitating intestinal condition, manifesting as Crohn’s disease (CD), ulcerative colitis (UC) or indeterminate colitis (IC). The patient experience is impacted by a lack of awareness from other stakeholders despite growing global disease prevalence. To gain deeper insight of the patient experience, promote quality care, and enhance quality of life, we performed a qualitative study of the patient journey starting from pre-diagnosis through treatment. Methods U.S. patients with IBD were recruited via UC/CD support groups and organizations, social media platforms, blog followers, and personal networks. Participants were screened via an emailed survey and asked to self-identify as medically diagnosed on the basis of reported diagnostic testing. Interviews were conducted by qualitative researchers by phone or web conferencing. Open-ended questions were developed to support and gather information about our learning objectives—primarily, our desire to understand the unique experiences of UC/CD patients in their journey from symptom onset through diagnosis, treatment and maintenance (e.g. “Upon diagnosis, what were your immediate thoughts about the condition?”). This qualitative data were analyzed using Human-Centered Design methodology, including patient typologies (personas), forced temporal zoom (journey maps), forced semantic zoom (stakeholder system mapping), and affinity mapping for pattern recognition of unmet needs. Results A total of 32 patients were interviewed: N=17 CD patients, N=13 UC patients and N=2 IC patients. The interviewed population reflected regional, demographic, and disease-related diversity (Table 1). Five unique, mutually exclusive journeys were identified to understand and classify patient experiences: (1) Journey of Independence, (2) Journey of Acceptance, (3) Journey of Recognition, (4) Journey of Passion and (5) Journey of Determination (Figure 1). Patients with IBD expressed a need for increased awareness, education, and training for providers to shorten the path to diagnosis. Mental health support was found to be a critical gap in care, particularly for major treatment decisions (e.g., surgery). The inclusion of emotional support into the treatment paradigm was perceived as essential to long-term wellness. Patient attitudes and self-advocacy varied on their individual journeys; understanding these journeys may accelerate time to diagnosis and treatment. Conclusion Better understanding of patient journeys can help healthcare providers improve their approach to patient care and coordination.

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Serologic testing for inflammatory bowel disease

The Journal of Pediatrics ◽

10.1016/s0022-3476(99)70202-7 ◽

1999 ◽

Vol 134 (4) ◽

pp. 447-452 ◽

Cited By ~ 71

Author(s):

Edward J. Hoffenberg ◽

Sara Fidanza ◽

Angela Sauaia

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Serologic Testing ◽

Inflammatory Bowel

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Incidence of Inflammatory Bowel Disease in Kaunas Region, Lithuania

Medicina ◽

10.3390/medicina48080064 ◽

2012 ◽

Vol 48 (8) ◽

pp. 64 ◽

Cited By ~ 2

Author(s):

Gediminas Kiudelis ◽

Laimas Jonaitis ◽

Kęstutis Adamonis ◽

Aida Žvirblienė ◽

Algimantas Tamelis ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Disease ◽

Western Europe ◽

Age At Onset ◽

Its Region ◽

Indeterminate Colitis ◽

Inflammatory Bowel

Objective. The aim of this study was to evaluate the incidence of inflammatory bowel disease in Kaunas and its region during a 3-year period. Material and Methods. The study was conducted during the 3-year period (2007–2009) and enrolled the patients from Kaunas with its region, which has a population of 381 300 inhabitants. The data were collected from all practices in the area where the diagnosis of inflammatory bowel disease was made by practicing gastroenterologists and consulting pediatricians along with endoscopists. Only new cases of inflammatory bowel disease were included into analysis. The diagnosis of ulcerative colitis and Crohn’s disease was strictly made according to the Copenhagen criteria. Age- and sex-standardized incidence was calculated for each year of the study period. Results. A total of 108 new inflammatory bowel disease cases were diagnosed during the study period: 87 had ulcerative colitis, 16 Crohn’s disease, and 5 indeterminate colitis. The incidence of ulcerative colitis, Crohn’s disease, and indeterminate colitis for each study year was 6.85, 5.33, and 7.38 per 100 000; 0.95, 1.11, and 1.57 per 100 000; and 0.47, 0.21, and 0.42 per 100 000, respectively. The average 3-year standardized incidence of ulcerative colitis, Crohn’s disease, and indeterminate colitis was 6.52, 1.21, and 0.37 per 100 000, respectively. The mean patients’ age at onset of ulcerative colitis, indeterminate colitis, and Crohn’s disease was 49.95 (SD, 17.03), 49.80 (SD, 17.71), and 34.94 years (SD, 0.37), respectively. Conclusions. The average 3-year incidence of ulcerative colitis in Kaunas region was found to be lower as compared with that in many parts of Central and Western Europe. The incidence of Crohn’s disease was low and very similar to other countries of Eastern Europe. Age at onset of the diseases appeared to be older than that reported in the Western industrialized countries.

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Diagnostic Radiation Exposure in Patients with Inflammatory Bowel Disease

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2019/2030735 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Catherine Langevin ◽

Lysanne Normandeau ◽

Mickael Bouin

Keyword(s):

Inflammatory Bowel Disease ◽

Radiation Exposure ◽

Bowel Disease ◽

Indeterminate Colitis ◽

Number Of Patients ◽

Inflammatory Bowel ◽

The Mean ◽

Effects Of Radiation ◽

And Control

Background. Because of the chronic and relapsing nature of inflammatory bowel disease (IBD), which often requires characterization with CT scan, IBD patients might be exposed to a large amount of radiation. As a cumulative effective dose (CED) ≥ 100 mSv is considered significant for stochastic risks of cancer, it is important to monitor and control the radiation exposure of the IBD patients. In the present work, we aimed to quantify the mean CED in IBD patients to assess any harmful effects of radiation. Methods. This study includes 200 IBD patients, identified retrospectively, from the outpatient clinics of the Centre Hospitalier de l’Université de Montréal between January 1, 2010, and February 15, 2017, from the gastroenterologists’ patients lists. The number and type of each radiology test performed were listed for each patient during the study period and the CED was calculated using our institution’s dose index when available and standardized tables. Results. Among the 200 IBD patients, 157 patients had Crohn’s disease (CD), 41 had ulcerative colitis (UC), and 2 had indeterminate colitis. The mean CED for IBD patients was 23.1 ± 45.2 mSv during a mean follow-up duration of 4.3 years. CED was higher among patients with CD than with UC (27.5 ± 49.5 versus 6.8 ± 14.8 mSv; p<0.01). Six patients were exposed to a high CED (>100 mSv) and all had CD. Conclusion. While potentially harmful levels of radiation exposure are of concern in only a small number of patients, strategies to limit such exposure are encouraged when clinically appropriate.

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Faecal markers of gastrointestinal inflammation

Journal of Clinical Pathology ◽

10.1136/jclinpath-2012-200901 ◽

2012 ◽

Vol 65 (11) ◽

pp. 981-985 ◽

Cited By ~ 38

Author(s):

Roy A Sherwood

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Waiting Times ◽

Indeterminate Colitis ◽

Faecal Calprotectin ◽

Infectious Colitis ◽

Inflammatory Conditions ◽

Gi Symptoms ◽

Rome Iii ◽

Inflammatory Bowel

Gastrointestinal (GI) symptoms including abdominal pain, bloating and diarrhoea are a relatively common reason for consulting a physician. They may be due to inflammatory bowel disease (inflammatory bowel disease; Crohn's disease, ulcerative colitis and indeterminate colitis), malignancy (colorectal cancer), infectious colitis or irritable bowel syndrome (IBS). Differentiation between these involves the use of clinical, radiological, endoscopic and serological techniques, which are invasive or involve exposure to radiation. Serological markers include C-reactive protein, erythrocyte sedimentation rate and antibodies (perinuclear antineutrophil cytoplasm antibody and anti-Saccharomyces cerevisiae antibody). Faecal markers that can aid in distinguishing inflammatory disorders from non-inflammatory conditions are non-invasive and generally acceptable to the patient. As IBS accounts for up to 50% of cases presenting to the GI clinic and is a diagnosis of exclusion (Rome III criteria), any test that can reliably distinguish IBS from organic disease could speed diagnosis and reduce endoscopy waiting times. Faecal calprotectin, lactoferrin, M2-PK and S100A12 will be reviewed.

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Characteristics of Inflammatory Bowel Disease Serology in Patients With Indeterminate Colitis

Journal of Clinical Gastroenterology ◽

10.1097/mcg.0000000000000083 ◽

2014 ◽

Vol 48 (4) ◽

pp. 351-355 ◽

Cited By ~ 7

Author(s):

Siddharth P. Sura ◽

Awais Ahmed ◽

Adam S. Cheifetz ◽

Alan C. Moss

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Indeterminate Colitis ◽

Inflammatory Bowel

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188 Accuracy of Preoperative Serologic Testing in Patients Undergoing Intestinal Resection for Inflammatory Bowel Disease

Gastroenterology ◽

10.1016/s0016-5085(09)60159-1 ◽

2009 ◽

Vol 136 (5) ◽

pp. A-35

Author(s):

Nicolas M. Intagliata ◽

Brian R. Swenson ◽

Charles M. Friel ◽

Eugene F. Foley ◽

Brian W. Behm

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Intestinal Resection ◽

Serologic Testing ◽

Inflammatory Bowel

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P626 SARS-CoV-2 seroprevalence in patients with Inflammatory Bowel Disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.746 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S564-S564

Author(s):

S García Mateo ◽

S J Martínez-Domínguez ◽

M C Aso Gonzalvo ◽

C J Gargallo-Puyuelo ◽

B Gallego Llera ◽

...

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Potential Risk ◽

Bowel Disease ◽

Biologic Agents ◽

World Health ◽

Indeterminate Colitis ◽

Increased Risk ◽

Potential Risk Factors ◽

Inflammatory Bowel

Abstract Background Patients with Inflammatory Bowel Disease (IBD) suffer from a chronic illness and many of them need immunosuppressive therapy throughout the course of the disease. Consequently, COVID-19 pandemic has caused uncertainty about the possible increased risk of suffering SARS-CoV-2 infection that could confer IBD or its treatments. The aim of this study is to assess SARS-CoV-2 seroprevalence in patients with IBD as well as the existence of potential risk factors for its development. Methods This is a unicentric cross-sectional study developed in IBD unit of University Hospital “Lozano Blesa” of Zaragoza. Patients older than 18 years with established diagnosis of Crohn′s Disease (CD), Ulcerative Colitis (UC) or Indeterminate Colitis (IC) have been included. A blood sample has been drawn from each patient to detect IgG against SARS-CoV-2 (ELISA method) and each patient has completed a questionnaire to know symptoms related to infection and previous comorbidity. We have performed a descriptive analysis and a univariate analysis to study relationship between potential risk factors and seroconversion against SARS-CoV-2. Results 431 patients have been included, with a mean age of 50.2 ± 14.1 years and a 51.3% of women. Of them, 49.7% suffer from UC, 49.2% CD and 1.2% IC. Related to the treatment, 23.5% receive anti-TNF biologic agents, 13.1% other kind of biologic agents, 9.3% immunomodulators, 7.7% combined treatment (biologic agent and immunomodulator), 33.1% other treatment and 13.3% no treatment. According to World Health Organization (WHO) definitions, 85.6% had not suffered the infection, 7.7% were confirmed cases (only 3 admitted patients) and 6.7% were probable cases. The seroprevalence of SARS-CoV-2 obtained is 8.8%, being significantly higher among confirmed cases than among probable cases (71.0% in confirmed vs 6.9% in probable; RR 10.3; p<0.001). A higher risk of seroconversion has been detected among patients without biologic agents (11.8% in patients without biologic agents vs 5.3% in patients with biologic agents; RR 2.2; p=0.021). No differences have been observed in the seroprevalence of patients with other treatments for IBD or in terms of age, active smoking, level of inflammation markers, the presence of symptoms of infection or hospital admission. Conclusion The seroprevalence of SARS-CoV-2 of Aragon′s patients with IBD is similar to that described in national seroprevalence study of Ministry of Health for the region (8.8%). The treatment with biologic agents is associated with a lower risk of seroconversion

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Outcome of Cytomegalovirus Colitis in Inflammatory Bowel Disease with Different Regimes of Ganciclovir

Middle East Journal of Digestive Diseases ◽

10.15171/mejdd.2018.114 ◽

2018 ◽

Vol 10 (4) ◽

pp. 220-229 ◽

Cited By ~ 3

Author(s):

Iftikhar Ahmed ◽

Wael Kassem ◽

Yazen Salam ◽

Manuele Furnari ◽

Tina Mehta

Keyword(s):

Inflammatory Bowel Disease ◽

Clinical Outcome ◽

Clinical Response ◽

Bowel Disease ◽

Oral Treatment ◽

Indeterminate Colitis ◽

Cmv Infection ◽

Poor Outcome ◽

Inflammatory Bowel ◽

Cmv Colitis

BACKGROUND Cytomegalovirus (CMV) infection is common in individuals with inflammatory bowel disease (IBD) and is responsible for relapse, increased severity, and poor outcome if left untreated. Ganciclovir is the mainstay of treatment but data regarding its use, mode of administration, and duration of treatment is poorly described. We reviewed the practice of treating CMV colitis with different regimes of ganciclovir at a district NHS hospital to compare the clinical outcome. METHODS 35 patients with IBD and concurrent diagnosis of CMV infection were evaluated. The parameters studied were clinical outcome in term of clinical response, length of hospital stay, readmission, or colectomy with three different regimes of ganciclovir, in addition to treatment for IBD. RESULTS 35 patients with IBD (ulcerative colitis = 23, Crohn’s disease = 5, Indeterminate colitis = 7) and positive diagnosis of CMV infection were studied. Clinical outcome with two weeks of intravenous (IV) ganciclovir regime was superior than one week of IV ganciclovir and two weeks of oral Valganciclovir in term of clinical response on day 15 (95.8% vs 74%, 24.3%, respectively p = 0.45) and colectomy rate within 3 months (6.25% vs 27.3%, vs 25%, respectively). CONCLUSION CMV colitis is associated with poor outcome in patient with IBD if left untreated. 2 weeks IV ganciclovir was associated with a better outcome than 1 week of IV treatment or oral treatment.

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