Utility of IBD Serology Tests: Experience of an Academic Center

BACKGROUND: The diagnosis of inflammatory bowel disease (IBD) is based on clinical, radiographic, endoscopic and histological criteria. Recently, serology tests involving antibodies against microbial and auto-antigens have been increasingly used for the diagnosis and management of IBD. However, the clinical value of these tests is still being evaluated and debated. Therefore, we conducted a retrospective study in our academic center to evaluate the sensitivity and specificity of the IBD serological tests.METHODS: A retrospective study was done at the University of MissouriColumbia from March 20, 1998 to February 22, 2008 involving all patients who underwent serology testing consisting of Prometheus IBD First Step Confirmatory System or IBD Serology 7. Patients were identified by a search conducted through Prometheus Laboratories and an extensive chart review was performed. Results of serology studies and final diagnoses (based upon all clinical criteria) were identified and recorded for each patient. Statistical analysis was performed in which the sensitivity and the specificity were calculated. RESULTS: The search identified 173 patients between the ages of 18 to 82 years, 100 females and 73 males. The sensitivity and specificity of the IBD First Step Confirmatory System was 54.8% and 86.5%, respectively. The sensitivity and specificity of the IBD serology 7 was 80% and 61.5%, respectively. CONCLUSIONS: The sensitivity and specificity of the IBD serology tests performed in our tertiary-care center was much lower than previously reported. Further studies into these factors may be helpful to further elucidate the role of IBD serology testing.