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Help make sense of my son's IBD Serology 7 test

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Crohn's Disease
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Posted 6/28/2008 4:53 AM (GMT 0)

This is the first time Ive come to this site.  We have a 5 yr old son with many medical issues and has had GI issues/Reflux/Pain/chronic diarrhea all his life. He never took to solid foods as a baby and is nearly 100% tube fed. He also has been diagnosed with a unspecified Myopathy thru a muscle biopsy.

Im hoping someone here can help me with his results.

He had the Prometheus IBD serology 7 test done.

 

Here's the results: Pattern NOT consistent with IBD.

Patient Assay Information:

ASCA IgA:  <12.0 EU/ml

ASCA IgG:  <12.0 EU/ml

Anti-OmpC IgA: 0.3 EU/ml---Is this also high? and out of range?

Anti-CBir1:  90.4 EU/ml---This one IS out of range.

Auto Antibody: <12.1 EU/ml

IFA Perinuclear Pattern:  Not Detected --Any idea what this is?

DNAse Sensitivity: Not Detected --Any idea what this is?

 

J's Colonoscopy Biopsy results showed many Eosinophils in the Colon and Small bowel. He also has a lot of inflammaton seen on an Upper GI/small bowel foolow thru xray. NO neutrophils were found and his colon looked very good visually. When they took the biopsies though, he bled more than normal, fragile walls.

After getting these results, we were told he DID NOT have Crohns or at least its reasonble to say we were looking at a Eosinophilic disease because of the eos found. We were told he had Eosinophilc enteritis/coiltis.

BUT what does the high numbers mean in the serology report? Mostly the Anti-CBir1? Is that a high number? And what does it mean if the critical markers of Crohns numbers were within range but this one not?

Can you have lots of eos found in both the colon and small bowel with Crohns as well? OR does this indicate only Eosinophilic disease? Can you have BOTH the Crohns and a Eosinophilic disease?? How common is it to find eos with Crohns?

Im so frustrated with all this. His formula was changed to Elecare and we removed almost everything from his diet. He's now scheduled to have a capsule endo done to see whats going on in the intsetines that the Drs cant get to from either upper or the lower scopes.

Anyone have experience with the capsule endo?

If anyone can help make out what these numbers mean, I would really appreciate your thoughts.

Thanks so much.

Hugs.

Posted 6/28/2008 7:33 AM (GMT 0)
check with prometheus labs or try searching online or ask the doctor of the ranges. I found this in a google search of anti-CBir1

Blood tests for Crohn's and colitis blood tests and the link of altered gut flora in IBD.

What is anti-CBir1 antibody?
Prometheus Laboratories has only recently added this antibody test. {wednesday, January 17, 2007} It is an antibody to the flagella protein on bacteria that enables movement and attachment of the bacteria in the intestine. When the anti-CBir1 antibody is present in high levels, especially when ASCA and/or OmpC are also present, Crohn’s disease is present.

 http://thefooddoc.blogspot.com/2007/01/crohns-and-colitis-blood-tests-what-are.html

Recall however, the NOD2 gene is a defective gene in crohns. It is a gene that deals with bacteria. Antibodies are the bodies defense. Prometheus is seeing if these particular antibodies are present then if crohns might be present. The antibodies might be present to fight bacteria or from defective crohns gene or both, if i understand it correctly.

 

Posted 6/28/2008 7:16 PM (GMT 0)
The only one out of range is CBir1. That is a high number. The CBir1 and OmpC markers may be elevated (ie false positive) if a person has had a urinary tract/bladder infection with uropathogenic E. coli. Not sure if that would apply to your son.

The Serology7 test is not 100% accurate. The biopsy results are more of the "gold standard" in terms of diagnosis, at least IMO. With Crohn's there are signs of chronic inflammation but many eosinophils in the biopsy are not typical.
Posted 6/28/2008 9:38 PM (GMT 0)
To completely rule it out you have to do a scope, I think a pill cam is a good idea.
Posted 6/29/2008 2:04 AM (GMT 0)
Thanks everyone for your thoughts on this, I appreciate you taking the time to reply.

I would just think that if this marker was SOOO important then why would it come back negative for IBD? ALSO I would think that if he had Crohns then the Pathologist would of wrote something in the report saying he was suspicious of Crohns or something? Or you would think anyways. It only talked about the Eosinophils as being prominent and above normal, nothing about Crohns. Plus Jack is quite young to have Crohns, not as common to be diagnosed so young.

My sons GI said that since we couldnt see the part thats inflammed then we may NOT of caught the Crohns with his colonscopy Biopsy. This is why she wants to do the capsule endo to see if we can take a better look at whats going on in that section. I also think its a good idea but I hope they dont just assume its Crohns given he has so many eosinophils--this would mean he would have both the Crohns and Eosinophilic disease, wouldnt it?

Thanks again.

Heidi and lil jack.
Posted 6/29/2008 11:09 AM (GMT 0)
Yes, you can have EOS disease and IBD. They are two distinct diseases, but similar in symptoms. Elevated eosinophils are not an indicator of IBD, but of the diagnosis they've given you son.

EOS is more common in boys and typically diagnosed very young. It's a very new disease, in terms of the docs diagnosing and understanding it. I've been to a few professional conferences about it, as well as a pt education conference and they've really only started to figure EOS out in the past 10 years or so. Compared to IBD they do use steroids, but the other treatments are different with elimination diets and such. If you are looking for a GI doctor who specializes in EOS, I work with 2. They're in Chicago. The other place that's huge into researching/treating EOS is Cincinnati Children's hospital.
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