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Serum α1-Antitrypsin Levels as a Marker of Activity in Pediatric Inflammatory Bowel Disease

M J Pettei1, J J Levine

  • 1Division of Pediatric Gastroenterology and Nutrition, Schneider Children's Hospital-Long Island Jewish Medical Center, Long Island Campus for the Albert Einstein College of Medicine, New Hyde Park, New York, U.S.A.

Inflammatory Bowel Diseases
|January 4, 2013
PubMed

Insights

Alpha-1 antitrypsin (α1-AT) shows higher sensitivity and specificity than erythrocyte sedimentation rate (ESR) for diagnosing inflammatory bowel disease (IBD) and predicting disease activity in children.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Chemistry
  • Inflammatory Bowel Disease Research

Background:

  • Inflammatory bowel disease (IBD) diagnosis and monitoring rely on various inflammatory markers.
  • Erythrocyte sedimentation rate (ESR) is a commonly used but sometimes limited marker for inflammation.

Purpose of the Study:

  • To compare the diagnostic and prognostic value of alpha-1 antitrypsin (α1-AT) against ESR, platelet count, and hemoglobin in pediatric IBD patients.
  • To assess α1-AT's utility in screening for inflammation in newly diagnosed and known IBD cases.

Main Methods:

  • Serum α1-AT levels, ESR, platelet count, and hemoglobin were measured in 154 children evaluated for IBD and 113 with known IBD.
  • Sensitivity and specificity of α1-AT and ESR were calculated for initial diagnosis of Crohn's disease (CD) and ulcerative colitis (UC).
  • These markers were also evaluated for predicting disease activity in established CD and UC.

Main Results:

  • For initial CD diagnosis, α1-AT demonstrated 100% sensitivity and 92% specificity, outperforming ESR (68%, 94%).
  • For initial UC diagnosis, α1-AT showed 70% sensitivity and 92% specificity, compared to ESR (61%, 94%).
  • In known IBD patients, α1-AT was more sensitive and specific than ESR for predicting disease activity in both CD and UC.

Conclusions:

  • Serum α1-AT levels are a more sensitive and specific marker than ESR for the initial diagnosis of pediatric CD.
  • α1-AT effectively predicts disease activity in both pediatric Crohn's disease and ulcerative colitis, surpassing ESR.
  • α1-AT represents a valuable tool for assessing inflammatory activity in pediatric IBD patients.

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