A Critical Evaluation of Serologic Markers for Inflammatory Bowel Disease

A 44-year-old woman with abdominal pain of 4 months’ duration is referred to your gastroenterology clinic from her primary care physician for evaluation of positive serologic markers for IBD. The patient denies diarrhea, bright red blood per rectum, melena, fevers, and weight loss. She has normal liver function test results, complete blood count, erythrocyte sedimentation rate, and C-reactive protein. There is no family history of IBD. She has undergone an upper endoscopy, a colonoscopy, and a small bowel series, all of which have been normal.

Abbreviations used in this paper: anti-Cbir1, antibodies to the bacterial flagellin Cbir1, anti-ompC, antibodies to the outer membrane porin C of the bacteria Eschericia coli, ASCA, antibodies to the yeast Saccharomyces cerevisiae, CD, Crohn’s disease, IBD, inflammatory bowel disease, pANCA, perinuclear antineutrophil cytoplasmic autoantibodies, UC, ulcerative colitis