IBD SGI Diagnostic Panel
Order Code: IBDSGI
Epic Lab Code: LAB3400
Order Form: A-1a Miscellaneous Request or Epic Req
Commercial Mail-out Laboratory
01250 PFP
356-3527
Specimen(s):
Serum and EDTA
Collection Medium:
and
Red top tube Lavender top tube 3 mL (EDTA)
Minimum:
2.0 mL serum in red top tube + 2.0 mL whole blood in (EDTA) lavender top tube. Both tube types are required.
Turn Around Time:
3-4 days upon receipt at reference laboratory
Reference Range:
NOTE: Patient test results are based on the Smart Diagnostic Algorithm which interprets patterns among the assay and values. Serology: ASCA IgA ELISA: <8.5 EU/mL ASCA IgG ELISA: <17.8 EU/mL Anti-OmpC IgA ELISA: <10.9 EU/mL Anti-CBir1 ELISA: <78.4 EU/mL Anti-A4-Fla2 IgG ELISA: <44.8 EU/mL Anti-FlaX IgG ELISA: <33.4 EU/ml AutoAntibody ELISA: <19.8 EU/mL IFA Perinuclear Pattern: Not Detected DNAse Sensitivity: Not Detected Genetics: ATG16L1 SNP (rs2241880): No Mutation Detected EMC1 SNP (rs3737240): No Mutation Detected NKX2-3 (rs10883365): No Mutation Detected STAT3 SNP (rs744166): No Mutation Detected Inflammation: ICAM-1: <0.54 μg/mL VCAM-1: <0.68 μg/mL VEGF: <345 pg/mL CRP: <13.2 mg/L SAA: <10.9 mg/L
Comments:
This mailout test requires pathologist approval for orders during inpatient encounters. Mailouts staff will not process order without approval. The pathologist covering mailouts approval can be reached at pager #5379. If approval is given, the name of the pathologist can be selected in the drop-down menu to the right of the approval warning in Epic when ordering the test.

This test aids in differentiating IBD vs non-IBD and Crohn's Disease vs Ulcerative Colitis in one comprehensive blood test.

This assay includes 9 serological markers including the proprietary Anti-Fla-X, Anti-A4-Fla2, Anti-CBir1, Anti-OmpC, and DNAse-sensitive pANCA that helps identify patients with IBD and utilizes Smart Diagnostic Algorithm Technology to improve the predictive accuracy. Genetic susceptibility influences immune responses and this assay includes evaluation of ATG16L1, STAT3, NKX2-3, and ECM1. Inflammatory markers include VEGF, ICAM, VCAM, CRP, SAA. While most other labs only offer assay values, the reference laboratory provides added clarity in diagnosing IBD, UC, and CD.

The reference laboratory services provide important information to aid in the diagnosis and management of certain diseases. Test results should be used with other clinical and diagnostic findings to make a diagnosis and prognosis. This test was developed and its performance characteristics determined by the reference laboratory and has not been cleared or approved by the U.S. Food and Drug Administration.
Methodology:
Enzyme-linked immunosorbent Assays (ELISA) and indirect immunofluorescent assays
CPT Code:
81479