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Screening laboratory tests for Crohn's disease.

D W Thomas, F R Sinatra

    The Western Journal of Medicine
    |February 1, 1989
    PubMed
    Summary

    Fecal alpha 1-antitrypsin (FA) concentration is the most sensitive screening test for pediatric Crohn's disease. Children without abnormal FA values, anemia, elevated ESR, or hypoalbuminemia are unlikely to have active disease.

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    Area of Science:

    • Pediatric Gastroenterology
    • Inflammatory Bowel Disease Research
    • Clinical Diagnostics

    Background:

    • Crohn's disease (CD) is a chronic inflammatory bowel disease.
    • Accurate and early diagnosis in pediatric patients is crucial.
    • Screening laboratory tests can aid in identifying potential CD cases.

    Purpose of the Study:

    • To evaluate the prevalence of abnormal screening laboratory test values in children diagnosed with Crohn's disease.
    • To identify the most sensitive screening tests for pediatric CD.

    Main Methods:

    • Retrospective analysis of 24 pediatric patients with confirmed Crohn's disease.
    • Assessment of initial screening laboratory tests: fecal alpha 1-antitrypsin (FA) concentration, erythrocyte sedimentation rate (ESR), leukocyte count, serum albumin, hemoglobin, and stool occult blood.
    • Correlation of abnormal test results with the diagnosis of Crohn's disease.

    Main Results:

    • All 24 patients (100%) exhibited at least one abnormal screening test value.
    • Fecal alpha 1-antitrypsin (FA) concentration was abnormal in 21 patients (87.5%).
    • Other frequent abnormalities included anemia (70.8%), elevated ESR (79.2%), and hypoalbuminemia (58.3%). Leukocytosis was not observed.

    Conclusions:

    • Fecal alpha 1-antitrypsin (FA) concentration is a highly sensitive screening marker for pediatric Crohn's disease.
    • The combination of screening tests effectively identifies potential CD cases.
    • Pediatric patients lacking abnormalities in FA, anemia, ESR, and albumin are unlikely to have active Crohn's disease, aiding in differential diagnosis.

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