Diagnostic utility of anti-Saccharomyces cerevisiae antibody (ASCA) and Interferon-gamma assay in the differential diagnosis of Crohn's disease and intestinal tuberculosis

Title
Diagnostic utility of anti-Saccharomyces cerevisiae antibody (ASCA) and Interferon-gamma assay in the differential diagnosis of Crohn's disease and intestinal tuberculosis
Author(s)
장병익김유선[김유선]김영호[김영호]김원호[김원호]김주성[김주성]박영숙[박영숙]양석균[양석균]예병덕[예병덕]정성애[정성애]진윤태[진윤태]최창환[최창환]한동수[한동수]
Keywords
INFLAMMATORY-BOWEL-DISEASE; ANTINEUTROPHIL CYTOPLASMIC AUTOANTIBODIES; EPIDEMIOLOGY; MANAGEMENT; DISTRICT; BIOPSIES; BAKERS; YEAST; INDIA; RISK
Issue Date
201108
Publisher
ELSEVIER SCIENCE BV
Citation
CLINICA CHIMICA ACTA, v.412, no.17-18, pp.1527 - 1532
Abstract
Background: Differential diagnosis of Crohn's disease (CD) from intestinal tuberculosis (ITB) is challenging. Anti-Saccharomyces cerevisiae antibody (ASCA) is a specific serological marker for CD and INF-gamma assay (QuantiFERON-TB gold test, QFT) is a good supplementary diagnostic tool for ITB. We evaluated the clinical usefulness of ASCA and QFT for differential diagnosis of CD from ITB in Korean adults. Methods: A total of 147 patients suspected to have ITB or CD were prospectively enrolled from 13 hospitals. ASCA IgG and IgA serum titers were measured by ELISA, and the QFT test was also performed. Results: Thirty-two of 72 (44.4%) patients with CD were ASCA positive (titer >25 U) compared to 10 of 75 ITB patients (13.3%) and 3 of 20 healthy controls (15%) (p<0.01). The QFT test was positive in 7 patients with CD (9.7%) and 50 patients with ITB (66.6%) (p<0.01). In cases which ASCA positive/QFT negative, the sensitivity, specificity, positive predictive value, and negative predictive value for the diagnosis of CD were 44.4%, 96.0%, 91.4%, and 64.3%, respectively. Conclusion: ASCA is a useful diagnostic tool for CD in Korea, where ITB is prevalent. In particular, when ASCA is combined with QFT, effective differential diagnosis of CD from ITB is possible. 2011 Elsevier B.V. All rights reserved.
URI
http://hdl.handle.net/YU.REPOSITORY/24774http://dx.doi.org/10.1016/j.cca.2011.04.029
ISSN
0009-8981
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의과대학 > 내과학교실 > Articles
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