predictive value of anti glycan antibodies

[mercury6]

I'm a 37 year-old female. I have been experiencing abdominal bloating, recurring back and pelvic pain, low grade fevers and fatigue in the past two months.

I quit smoking five years ago. Alcohol consumption minimal. I maintain a healthy weight, low blood pressure and cholesterol. I eat a varied diet with fruits and vegetables. No injuries. Surgeries include two previous c-sections and an appendectomy.

Recent test results include a normal CBC; negative for Celiac's disease; normal urinalysis; metabolic and hepatic function panels normal; stool culture, O & P Exam, Giardia all negative, S. Cerevisiae Panel negative, (CA)125 normal. Pelvic exam and pelvic/abdominal ultrasound both normal. CT scan showed an area of low attenuation over my liver, but no pathology demonstrated.

My Crohn's Prognostic Panel resulted in positive results for both ASCA and ALCA. Does testing positive for these two anti glycan antibodies definitively predict that I will be diagnosed with Crohn's disease? Are they associated with other diseases?

Advice greatly appreciated.

[mercury6]

Thank you very much for the quick reply. Your help is very much appreciated.

[Kevin Pho, MD]

ASCA positive tests have a relatively high specificity for Crohn's disease.  A small study followed ASCA positive patients and found that 8 of 10 of them later developed Crohn's disease later on.

CT enteroscopy or a small bowel follow-through are other tests that can be considered.

Another antibody test to consider is the anti-OmpC antibody, which also has been associated with both Crohn's disease and ulcerative colitis.  

As for other diseases that can lead to a positive ASCA level, autoimmune hepatitis is one.

These options can be discussed with your personal physician.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin Pho, M.D.

KevinMD.com
Twitter.com/kevinmd