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Laboratory Findings

  • Catherine ColmanEmail author
  • Marlene Stone
  • Alain Bitton
Chapter

Abstract

Diagnosing and treating inflammatory bowel disease (IBD) is a challenging process. Several criteria are required for a definite diagnosis. These include clinical presentation, endoscopic appearance, histological findings, as well as biochemical and laboratory investigations (ECCO, J Crohns Colitis 11(1):3–25, 2017; Vermiere et al., Gut 55:426–431, 2006). Laboratory investigations are noninvasive and usually accessible and inexpensive and an integral part of diagnosis and overall IBD management. They are essential in detecting infection and inflammation, in assessing malabsorption and nutritional deficiencies, and in monitoring the response to therapy. Considering the relapsing and remitting course of IBD, certain investigations or laboratory markers are available that can help guide detection for early intervention, which can lead to improved outcomes. Both serum and fecal markers are used routinely in IBD clinical practice. The most widely studied and used markers in IBD are C-reactive protein (CRP) and fecal calprotectin (FC). Several laboratory markers have been described in the literature but are not routinely used in clinical practice either because they are not readily available or have not gained favor. These include serum amyloid, alpha-1 antitrypsin, orosomucoid, and interleukin 6. Other essential laboratory markers in the management of IBD are also reviewed.

Keywords

Inflammatory bowel disease Biomarkers Fecal calprotectin C-reactive protein 

References

  1. Batres LA, Baldassano RN (2003) Evaluation of the patient suspected of having inflammatory bowel disease. In: Lichtenstein GR (ed) The clinician’s guide to inflammatory bowel disease. Slack, Thorofare, pp 315–323Google Scholar
  2. Bressler B, Panaccione R, Fedorak RN, Seidman EG (2015) Clinicians’ guide to the use of fecal calprotectin to identify and monitor disease activity in inflammatory bowel disease. Can J Gastroenterol Hepatol 29(7):369–372CrossRefGoogle Scholar
  3. Chang S, Malter L, Hudesman D (2015) Disease monitoring in inflammatory bowel disease. World J Gastroenterol: WJG 21(40):11246–11259.  https://doi.org/10.3748/wjg.v21.i40.11246 CrossRefPubMedGoogle Scholar
  4. Däbritz J, Musci J, Foell D (2014) Diagnostic utility of faecal biomarkers in patients with irritable bowel syndrome. World J Gastroenterol: WJG 20(2):363–375.  https://doi.org/10.3748/wjg.v20.i2.363 CrossRefPubMedGoogle Scholar
  5. ECCO (2017) Third European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016: part 1: diagnosis and medical management. J Crohns Colitis 11(1):3–25.  https://doi.org/10.1093/ecco-jcc/jjw16 CrossRefGoogle Scholar
  6. Kopylov U, Rosenfeld G, Bressler B, Seidman E (2014) Clinical utility of fecal biomarkers for the diagnosis and management of inflammatory bowel disease. Inflamm Bowel Dis 20(4):742–756.  https://doi.org/10.1097/01.MIB.0000442681.85545.31 CrossRefPubMedGoogle Scholar
  7. Mosli MH, Zou G, Garg SK, Feagan SG, MacDonald JK, Chande N, Sandborn WJ, Feagan BG (2015) C-reactive protein, fecal calprotectin, and stool lactoferrin for detection of endoscopic activity in symptomatic inflammatory bowel disease patients: a systematic review and meta-analysis. Am J Gastroenterol 110:802–819.  https://doi.org/10.1038/ajg.2015.120 CrossRefPubMedGoogle Scholar
  8. Papay P, Ignjatovic A, Karmiris K, Amarante H, Milheller P, Feagan B, Panaccione R (2013) Optimising monitoring in the management of Crohn’s disease: a physician’s perspective. J Crohns Colitis 7(8):653–669.  https://doi.org/10.1016/j.crohns.2013.02.005 CrossRefPubMedGoogle Scholar
  9. Qin G, Tu J, Liu L, Luo L, Wu J, Tao L et al (2016) Serum albumin and c-reactive protein/albumin ratio are useful biomarkers of Crohn’s disease activity. Med Sci Monit 22:4393–4400.  https://doi.org/10.12659/MSM.897460 CrossRefPubMedGoogle Scholar
  10. UpToDate (n.d.-b) Nutritional deficiencies in inflammatory bowel disease. https://www.uptodate.com/contents/nutrient-deficiencies-in-inflammatory-bowel-disease#H5. Accessed 15 Apr 2017
  11. Vermiere S, Van Assche G, Rutgeerts P (2006) Laboratory markers in IBD: useful, magic, or unnecessary toys? Gut. 55:426–431.  https://doi.org/10.1136/gut.2005.069476 CrossRefGoogle Scholar
  12. Voudoukis E, Karmiris K, Koutroubakis IE (2014) Multipotent role of platelets in inflammatory bowel diseases: a clinical approach. World J Gastroenterol: WJG 20(12):3180–3190.  https://doi.org/10.3748/wjg.v20.i12.3180 CrossRefPubMedGoogle Scholar
  13. Walk-in-Lab (n.d.) White blood cells (WBC test), stool test. https://www.walkinlab.com/blood-disorder-tests/whitebloodcells-wbc-stooltest.html

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.McGill University Health Centre, Inflammatory Bowel Disease Centre, Montreal General HospitalMontrealCanada

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