SENSITIVITY AND POSITIVE PREDICTIVE VALUE OF INFLAMMATORY BOWEL DISEASE SEROLOGIC MARKERS IN YOUNG ADULTS AND CHILDREN

Inflammation may affect many routinely available parameters of iron homeostasis. Thus, the recognition of iron deficiency in inflammatory bowel disease (IBD) remains a diagnostic challenge in a clinical routine. The aim of the study was to detect the most efficient marker of iron deficiency in IBD children. In a group of 75 IBD children, we evaluated the sensitivity, specificity, accuracy, and positive and negative predictive values of erythrocytes’ indices, including MCV, MCH, MCHC and RDW, and biochemical markers, including iron, transferrin, sTfR and sTfR/log ferritin, for identifying iron deficiency. Receiver operating characteristic (ROC) analysis was used to compare the ability of these parameters to detect iron deficiency. The best predictors of iron deficiency were sTfR/log ferritin, with accuracy 0.86, sensitivity 0.98, specificity 0.63, positive predictive value 0.83 and negative predictive value 0.94, and sTfR, with accuracy 0.77, sensitivity 0.82, specificity 0.67, positive predictive value 0.82 and negative predictive value 0.67. Moreover, sTfR/log ferritin exhibited the largest area under ROC (0.922), followed by sTfR (0.755) and MCH (0.720). The sTfR/log ferritin index appears to be the most efficient marker of iron depletion in pediatric IBD, and it may give an added value in the management of IBD patients.

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M1150 The Sensitivity and Positive Predictive Value of Computerized Diagnoses, Procedures, and Drugs for Inflammatory Bowel Disease in a Northern California Managed Care Organization

Gastroenterology ◽

10.1016/s0016-5085(09)61653-x ◽

2009 ◽

Vol 136 (5) ◽

pp. A-360

Author(s):

Liyan Liu ◽

James E. Allison ◽

Lisa J. Herrinton

Keyword(s):

Inflammatory Bowel Disease ◽

Managed Care ◽

Positive Predictive Value ◽

Bowel Disease ◽

Predictive Value ◽

Care Organization ◽

Northern California ◽

Inflammatory Bowel ◽

Managed Care Organization

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Predictive Value of Serologic Markers in a Population-based Norwegian Cohort with Inflammatory Bowel Disease

Inflammatory Bowel Diseases ◽

10.1002/ibd.20781 ◽

2009 ◽

Vol 15 (3) ◽

pp. 406-414 ◽

Cited By ~ 31

Author(s):

Inger Camilla Solberg ◽

Idar Lygren ◽

Milada Cvancarova ◽

Jrgen Jahnsen ◽

Njaal Stray ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Predictive Value ◽

Population Based ◽

Serologic Markers ◽

Inflammatory Bowel

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Abdominal MRI without Enteral Contrast Accurately Detects Intestinal Fibrostenosis in Patients with Inflammatory Bowel Disease

The American Surgeon ◽

10.1177/000313481508101123 ◽

2015 ◽

Vol 81 (11) ◽

pp. 1118-1124

Author(s):

Jeremy G. Fisher ◽

Bobby Kalb ◽

Diego Martin ◽

Tanvi Dhere ◽

Sebastian D. Perez ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Magnetic Resonance ◽

Confidence Interval ◽

Positive Predictive Value ◽

Bowel Disease ◽

Predictive Value ◽

Magnetic Resonance Enterography ◽

Abdominal Mri ◽

Inflammatory Bowel

Patients with inflammatory bowel disease (IBD) presenting for surgical evaluation require thorough small bowel surveillance as it improves accuracy of diagnosis (ulcerative colitis versus Crohn's) and differentiates those who may respond to nonoperative therapy, preserving bowel length. MRI has not been validated conclusively against histopathology in IBD. Most protocols require enteral contrast. This study aimed to 1) evaluate the accuracy of MRI for inflammation, fibrosis, and extraluminal complications and 2) compare MRI without enteral contrast to standard magnetic resonance enterography. Adults with Crohn's disease or ulcerative colitis who underwent abdominal MRI and surgery were retrospectively reviewed. Of 65 patients evaluated, 55 met inclusion criteria. Overall sensitivity and specificity of MRI for disease involvement localized by segment were 93 per cent (95% confidence interval = 89.4–95.0) and 95 per cent (95% confidence interval = 92.3–97.0), respectively (positive predictive value was 86%, negative predictive value was 98%). Sensitivity and specificity between MRI with and without oral and rectal contrast were similar (96% vs 91% and 99% vs 94%, P > 0.10). As were positive predictive value and negative predictive value (85% vs 96%, P = 0.16; 97% vs 99%, P = 0.42). Magnetic resonance is highly sensitive and specific for localized disease involvement and extraluminal abdominal sequelae of IBD. It accurately differentiates patients who have chronic transmural (fibrotic) disease and thus may require an operation from those with acute inflammation, whose symptoms may improve with aggressive medical therapy alone. MRI without contrast had comparable diagnostic yield to standard magnetic resonance enterography.

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Systematic Review: Gastrointestinal Ultrasound Scoring Indices for Inflammatory Bowel Disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjaa129 ◽

2020 ◽

Author(s):

Thomas M Goodsall ◽

Tran M Nguyen ◽

Claire E Parker ◽

Christopher Ma ◽

Jane M Andrews ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Positive Predictive Value ◽

Bowel Disease ◽

Predictive Value ◽

Bowel Wall ◽

Risk Of Bias ◽

Gastrointestinal Ultrasound ◽

Inflammatory Bowel ◽

Sensitivity Specificity ◽

Index Components

Abstract Background and Aims Serial measurements of luminal disease activity may facilitate inflammatory bowel disease management. Gastrointestinal ultrasound is an easily performed, non-invasive alternative to other assessment modes. However, its widespread use is limited by concerns regarding validity, reliability, and responsiveness. We systematically identified ultrasound scoring indices used to evaluate inflammatory bowel disease activity and examine their operating characteristics. Methods Electronic databases were searched from inception to June 14, 2019 using pre-defined terms. Studies that reported on gastrointestinal ultrasound index operating properties in an inflammatory bowel disease population were eligible for inclusion. Study characteristics, index components, and operating property data [ie, validity, reliability, responsiveness, sensitivity, specificity, accuracy, positive predictive value, and negative predictive value] were extracted. The QUADAS-2 tool was used to examine study-level risk of bias. Results Of the 2610 studies identified, 26 studies reporting on 21 ultrasound indices were included. The most common index components included bowel wall thickness, colour Doppler imaging, and bowel wall stratification. The correlation between ultrasound indices and references standards ranged r = 0.62–0.95 and k = 0.40–0.96. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive values ranged 39–100%, 63–100%, 73–100%, 57–100%, and 40–100%, respectively. Reliability and responsiveness data were limited. Most [92%, 24/26] studies received at least one unclear or high risk of bias rating. Conclusions Several gastrointestinal ultrasound indices for use in inflammatory bowel disease have been developed. Future research should focus on fully validating existing or novel gastrointestinal ultrasound scoring instruments for assessment of Crohn’s disease and ulcerative colitis.

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22 PERSISTENT OPIOID USE AND HEALTHCARE UTILIZATION AMONG ADOLESCENTS AND YOUNG ADULTS WITH INFLAMMATORY BOWEL DISEASE IN THE UNITED STATES

Gastroenterology ◽

10.1053/j.gastro.2017.11.134 ◽

2018 ◽

Vol 154 (1) ◽

pp. S46

Author(s):

Anava Wren ◽

Rachel Bensen ◽

Lindsay Sceats ◽

Helen Yu ◽

Jessie Wong ◽

...

Keyword(s):

United States ◽

Inflammatory Bowel Disease ◽

Young Adults ◽

Healthcare Utilization ◽

Bowel Disease ◽

The United States ◽

Adolescents And Young Adults ◽

Opioid Use ◽

Inflammatory Bowel

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5-Aminosalicylate therapy is associated with higher 6-thioguanine levels in adults and children with inflammatory bowel disease in remission on 6-mercaptopurine or azathioprine

Inflammatory Bowel Diseases ◽

10.1097/01.mib.0000206544.05661.9f ◽

2006 ◽

Vol 12 (4) ◽

pp. 251-257 ◽

Cited By ~ 70

Author(s):

Scott Hande ◽

Noah Wilson-Rich ◽

Athos Bousvaros ◽

Anna Zholudev ◽

Rie Maurer ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Adults And Children ◽

Inflammatory Bowel

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Fecal calprotectin is an early predictor of endoscopic response and histologic remission after the start of vedolizumab in inflammatory bowel disease

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284820979765 ◽

2020 ◽

Vol 13 ◽

pp. 175628482097976

Author(s):

Renske W. M. Pauwels ◽

Christien J. van der Woude ◽

Nicole S. Erler ◽

Annemarie C. de Vries

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Predictive Value ◽

Fecal Calprotectin ◽

Clinical Decisions ◽

Inclusion Criteria ◽

Inflammatory Bowel ◽

A Prospective Study ◽

Colonic Biopsies ◽

Study Inclusion

Background and aims: Early prediction of the effect of vedolizumab (VDZ) in inflammatory bowel disease (IBD) is of paramount importance to guide clinical decisions. This study assessed whether early fecal calprotectin (FC) can predict endoscopic response and histologic remission after VDZ initiation. Methods: This was a prospective study. Inclusion criteria were endoscopic inflammation and FC >100 µg/g. FC was determined at baseline and weeks 2, 4, 8 and 16. At week 16, endoscopies with ileal and colonic biopsies were performed. FC changes were assessed with Wilcoxon Rank Sum tests. ROC statistics were used to assess the diagnostic accuracy of FC. Results: In total, 45 patients [27 Crohn’s disease (CD), 16/2 ulcerative colitis (UC)/IBD-unclassified] [40% males, median age 39 (28–51) years] were included. Week 16 endoscopic response and histologic remission rates were 58% and 33%. A median 37% decline in FC at week 2 was observed only in endoscopic responders, p = 0.025. FC <250 µg/g at week 8 predicted endoscopic response in both UC and CD (positive predictive value 100%), whereas absence of FC decline at week 8 corresponded with absence of endoscopic response in CD [negative predictive value (NPV) 82%] and absence of histologic remission in both UC and CD (NPV 90%). Conclusion: The onset of a decline in FC as early as week 2 is associated with endoscopic response to VDZ induction. FC <250 µg/g at week 8 is associated with endoscopic response, whereas absence of FC decline at week 8 is associated with absence of both endoscopic response and histologic remission. FC levels 8 weeks after the start of VDZ could be used to guide clinical decisions and might substitute for endoscopic response evaluation.

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