GI & Liver Disease Testing By Doctors For Doctors
|
|
- Laurence Pitts
- 7 years ago
- Views:
Transcription
1 GI & Liver Disease Testing By Doctors For Doctors Updated September 2013
2 GI & Liver Disease Panels Autoimmune GI Panels Inflammatory Bowel Disease Panel RDL s Inflammatory Bowel Disease (IBD) Panel combines two valuable diagnostic autoantibody markers: Anti-Saccharomyces cerevisiae Ab (ASCA) and atypical Perinuclear Antineutrophil Cytoplasmic Ab (atypical P-ANCA). ASCA antibodies (IgA & IgG) are the most sensitive for Crohn s Disease (CD) when atypical P-ANCA is negative, with a sensitivity of 55% and a specificity of 93%. Atypical P-ANCA antibodies have a sensitivity of 51.3% and a specificity of 94% for Ulcerative Colitis (UC) when ASCA is negative. For differentiating between IBD and non-ibd, the presence of either atypical P-ANCA or ASCA antibodies has a sensitivity of 62.6% and a specificity of 92.6%. Atypical P-ANCA is superior to ASCA for identifying IBD. However, atypical P-ANCA can be detected in CD and ASCA can be detected in UC in up to 20% of cases. Pancreatic antibody (PAB) has a sensitivity of 15-40% with a specificity of approximately 95% for CD. Addition of PAB to ASCA and atypical P-ANCA enhances both the sensitivity and specificity for IBD, and helps differentiate between UC and CD. The addition of Anti-OmpC IgA (Anti-Outer Membrane Protein C), Anti-CBir 1 (bacterial flagellin) and DNAse sensitive P-ANCA to ASCA and the more common formalin fixed atypical P-ANCA does not significantly enhance the predictive value for IBD. IBD Panel Anti-Saccharomyces cerevisiae Ab (ASCA), IgG Anti-Saccharomyces cerevisiae Ab (ASCA), IgA atypical Perinuclear Anti-Neutrophil Cytoplasmic Ab (atypical P-ANCA) Anti-Pancreatic Ab (PAB) Typical Results in IBD and Related Conditions Test ASCA, IgG ASCA, IgA atypical P-ANCA PAB Crohn s Disease Ulcerative Colitis IBD can be challenging to diagnose and differentiate from related GI disorders. Our Medical Directors are available to discuss any results.
3 Celiac Disease Panel, Comprehensive Celiac disease is an autoimmune disorder that occurs in genetically susceptible individuals in response to dietary gluten in wheat, rye and barley. In many Western countries, the disease affects approximately 1% of the population and studies show that the true prevalence of Celiac disease is increasing over time. Classical symptoms include the following: malabsorption, chronic diarrhea, iron deficiency anemia and weight loss. Extraintestinal manifestations include osteoporosis, dermatitis herpetiformis, neurological problems, liver disorders, arthritis and obstetric complications. Celiac disease is also associated with other autoimmune disorders such as Type 1 Diabetes Mellitus and autoimmune thyroid diseases. The gold standard in diagnosing Celiac disease is the presence of histological changes on small bowel mucosal biopsies. However, because of the multifaceted nature of the disease, clinicians use serum antibody testing to assist with diagnosis and, at times, screen for the disease. Sensitivities and Specificities of IgA-class Serologic Tests in Untreated Celiac Disease Test EMA Anti-AGA-DPG Anti-tTG Anti-Actin Ab, IgA Sensitivity 80-97% 74-98% 85-98% 86 93% Specificity % 90 99% 95 99% 81 90% RDL performs Total IgA level testing to detect IgA deficiency. IgA deficiency may cause all IgA antibodies to be absent. The sensitivity of IgG AGA-DPG is 82.3% with specificity of 98.9%. IgG AGA-DPG can be positive in patients with IgA deficiency when the other IgA antibodies are absent, thus improving screening and diagnosis of Celiac disease. Celiac Disease Panel, Comprehensive Anti-Gliadin Ab-Deaminated Gliadin Peptides (AGA-DGP), IgG Anti-Gliadin Ab-Deaminated Gliadin Peptides (AGA-DGP), IgA Anti-Endomysial Ab (EMA), IgA Tissue Transglutaminase Ab (ttg), Human IgA Anti-Actin Ab, IgA IgA, Total Celiac disease can be challenging to diagnose and differentiate from related intestinal disorders. Our Medical Directors are available to discuss any results.
4 Gluten Free Panel Our Gluten Free Panel is offered to verify patient compliance with a gluten free diet. If the antibodies decrease or disappear, it suggests the patient is likely in compliance with a gluten free diet. Gluten Free Panel Anti-Gliadin Ab-Deaminated Gliadin Peptides (AGA-DGP), IgG Anti-Gliadin Ab-Deaminated Gliadin Peptides (AGA-DGP), IgA Tissue Transglutaminase Ab (ttg), Human IgA Autoimmune Liver Disease Panels Autoimmune Hepatitis (AIH) is characterized by chronic, immune mediated inflammation of the hepatocytes. It is found predominantly in middle-aged women and if left untreated, the disease may progress to cirrhosis and end-stage liver disease. The clinical presentation of AIH can be variable and includes asymptomatic elevation of liver aminotransferases, as well as vague symptoms such as fatigue, malaise and arthralgias. The distinction between AIH type I and AIH type II is mainly based on serologies. The classic serologic markers of AIH I are ANA and smooth-muscle antibodies (SMA). SMA antibodies are directed against a few different antigens including actin. Anti-Actin IgG antibodies have been shown to have a sensitivity of 74% for AIH I. High titer SMA has a specificity of 96% but a sensitivity in some studies of only 16%. ANA has a sensitivity of 32% and specificity of 76% and is frequently seen in other chronic liver diseases including alcoholic liver disease. The combination of ANA and SMA provides a robust specificity of 99% but does not greatly improve sensitivity (43%). Anti-SLA (Anti-Soluble Liver Antigen) antibodies are the most specific (up to 100%) for AIH I, with a sensitivity of 10-30% (they can also be seen in AIH II). Atypical P-ANCA has a high prevalence in autoimmune hepatitis of 74-80% but is also found in Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis. Anti-Chromatin Antibodies are found in 40-50% of people with AIH I but are not very specific. AIH type II (also known as LKM [Anti-Liver/Kidney Microsomal]-positive autoimmune hepatitis) makes up about 4% of all AIH patients. Anti-LC1 (liver-specific cytosol antigen type 1) is also specific to AIH II; it generally occurs in conjunction with anti-lkm but in children it may be a sole presenting autoantibody. AMA (Anti-Mitochondrial Antibodies) occur in 5% of AIH patients in the absence of other biliary features. Total IgG levels can be elevated in AIH and may suggest IgG4-associated AIH with IgG4+ plasma cells found on liver tissue despite having normal IgG4 serum levels. Recent data also shows that Anti-Ribosomal P Antibodies can be found in 9.7% of AIH patients who do not have clinical SLE.
5 Autoimmune Liver Disease Panel Anti-Nuclear Ab (ANA) Anti-Actin Ab, IgG Anti-Soluble Liver Antigen Ab (SLAg Ab) atypical Perinuclear Anti-Neutrophil Cytoplasmic Ab (atypical P-ANCA) Anti-Liver/Kidney Microsomal I Ab (LKM) Anti-Mitochondrial M2 EP Ab (AMA-M2) Anti-Chromatin Ab IgG, Total Autoimmune Liver Disease can be challenging to diagnose and differentiate from related liver disorders. Our Medical Directors are available to discuss complex results. Primary Biliary Cirrhosis Panel Primary Biliary Cirrhosis (PBC) is an organ-specific autoimmune disease characterized by chronic progressive destruction of intrahepatic bile ducts with portal inflammation resulting in chronic cholestasis and ultimately fibrosis. Serologic assays are important tools for the recognition and diagnosis of PBC, since many antibodies associated with PBC can be present years before symptoms become evident. PBC typically occurs between the ages of 30 and 65 and affects more women than men by a ratio of 9:1. The range of prevalence for PBC in first-degree relatives is 1.3% to 6.4%. The detection of Anti-Mitochondrial Antibodies (AMA) by IFA has been reported in up to 95% of PBC patients with a specificity of 93%. In addition to AMAs, ANA antibodies are present in about 50% of PBC patients. Two nuclear fluorescence patterns are typically found in PBC on ANA IFA staining: a rim-like pattern resulting from autoantibody reaction with glycoprotein 210 (Gp210) and nucleoporin 62, and a pattern of multiple nuclear dots resulting from a reaction with Sp100 and promyelocytic leukaemia antigen. ELISA testing for Gp210 yields a sensitivity of 16-32%, while ELISA testing for Sp100 has a sensitivity of 21-39%. Both of these antibodies have a very high specificity, typically greater than 99% for PBC, and can detect up to 70% of AMA negative patients. Additionally, these antibodies may indentify a subgroup of patients with a more severe disease course. Other AMA negative patients can have antibodies against major M2 components that are present on ELISA testing (Anti-Mitochondrial M2 EP Antibodies), which also have a specificity of up to 100%. The presence of AMA is highly diagnostic of PBC and predictive of disease occurrence even in asymptomatic patients who do not have cholestasis. Primary Biliary Cirrhosis Panel Anti-Nuclear Ab (ANA) Anti-Mitochondrial Ab (AMA) by IFA Anti-Mitochondrial M2 EP Ab (AMA-M2) Anti-glycoprotein 210 Ab (anti-gp210 Ab) Anti-sp100 Ab Primary Biliary Cirrhosis can be challenging to diagnose and differentiate from related liver disorders. Our Medical Directors are available to discuss any results.
6 Clinical Expertise Our Medical Directors are board certified Internists & Rheumatologists. All of our technologists have over 15 years of experience in immunologic testing and interpretation. RDL has performed autoimmune testing in the fields of gastroenterology and hepatology for over twenty years, using FDA approved kits. RDL maintains an extensive serum bank of serologically characterized specimens for all high priority autoimmune markers. We use this repository to validate all test kits used by RDL. RDL has been CAP and CLIA certified since Personal Service All test results are reviewed by our Medical Directors who may contact you personally to discuss complex results, and are available for clinical consultation on any test results. Real people answer our phones, so you can get an immediate response to all your questions and concerns. We are a provider for Medicare and Blue Cross/Blue Shield, as well as many other insurances throughout the country, and we can usually adapt to your patient s insurance. We are sensitive to your patients financial concerns, and can offer unique plans to work within their budget. Cost Effective RDL s panels are more cost-effective than performing individual tests and provide more comprehensive results. An ANA is performed at no additional cost on all atypical P-ANCA positive samples. RDL offers free courier service throughout the United States. Please visit our website, for additional information and references. September 2013, RDL, Inc. RDL Reference Laboratory Creative Solutions for Complex Medicine Venice Boulevard Los Angeles, CA tel: fax:
Celiac Disease. Donald Schoch, M.D. Ohio ACP Meeting October 17, 2014
Celiac Disease Donald Schoch, M.D. Ohio ACP Meeting October 17, 2014 None to disclose Conflicts of Interest Format Present a case Do a pretest about the evaluation Review case Discuss the questions & answers
More informationNICE guideline Published: 2 September 2015 nice.org.uk/guidance/ng20
Coeliac disease: recognition, assessment and management NICE guideline Published: 2 September 2015 nice.org.uk/guidance/ng20 NICE 2015. All rights reserved. Contents Key priorities for implementation...
More informationIdentifying Celiac Disease and Gluten Sensitivity with Minimally Invasive Testing
Identifying Celiac Disease and Gluten Sensitivity with Minimally Invasive Testing Enjoy this white paper by Jack A. Maggiore, PhD, MT(ASCP), Assistant Director, Chemistry Laboratory and R&D at Doctor s
More informationSenasta forskningsrön i celiaki
Senasta forskningsrön i celiaki Markku Mäki Tammerfors Universitet och Universitetssjukhuset i Tammerfors, Tammerfors,, Finland Tammerfors 30.11.2007 Classical presentations of coeliac disease Coeliac
More informationLAB 1 - Direct agglutination. Serology-the study of the in vitro reactions between antibody and antigen
LAB 1 - Direct agglutination Serology-the study of the in vitro reactions between antibody and antigen Serological reaction: - quantitative (weight/volume) - qualitative Agglutination - the aggregation
More informationEvaluation of a Child with Elevated Transaminases. Linda V. Muir, M.D. April 11, 2008 Northwest Pediatric Liver Disease Symposium
Evaluation of a Child with Elevated Transaminases Linda V. Muir, M.D. April 11, 2008 Northwest Pediatric Liver Disease Symposium Disclosures I do not have a financial interest, arrangement or affiliation
More informationRheumatology Labs for Primary Care Providers. Robert Monger, M.D., F.A.C.P. 2015 Frontiers in Medicine
Rheumatology Labs for Primary Care Providers Robert Monger, M.D., F.A.C.P. 2015 Frontiers in Medicine Objectives Review the Indications for and Interpretation of lab testing for the following diseases:
More informationDrugs Believed Capable of Inducing Autoimmune Hepatitis
Drugs Believed Capable of Inducing Autoimmune Hepatitis Leonard B. Seeff, M.D. National Institutes of Diabetes and Digestive and Kidney Diseases National Institutes of Health Immune-Mediated Liver Diseases
More informationSelective IgA deficiency (slgad) hello@piduk.org 0800 987 8986 www.piduk.org
Selective IgA deficiency (slgad) hello@piduk.org 0800 987 8986 www.piduk.org About this booklet This booklet provides information on selective IgA deficiency (sigad). It has been produced by the PID UK
More informationGastroenterology Celiac Disease Update
Celiac Disease Update A majority of patients go undiagnosed due to a lack of understanding By Catlin Nalley 24 MAY/JUNE 2015 NURSE PRACTITIONER PERSPECTIVE www.advanceweb.com/nppa May is Celiac Disease
More informationClinical Guideline SYNOPSIS. Who to Test?
JOBNAME: gas 40#1 2005 PAGE: 1 OUTPUT: Wed December 15 18:39:15 2004 Prod #: MPG157309 MS #xxx Journal of Pediatric Gastroenterology and Nutrition 40:1 19 Ó January 2005 Lippincott Williams & Wilkins,
More informationAASLD PRACTICE GUIDELINES Diagnosis and Management of Autoimmune Hepatitis
AASLD PRACTICE GUIDELINES Diagnosis and Management of Autoimmune Hepatitis Michael P. Manns, 1 Albert J. Czaja, 2 James D. Gorham, 3 Edward L. Krawitt, 4 Giorgina Mieli-Vergani, 5 Diego Vergani, 6 and
More informationCoeliac disease. Which of your patients has coeliac disease?
Coeliac disease Which of your patients has coeliac disease? Over the past few decades, coeliac disease has gone from being a rare disease in children, to a public health problem. As head researcher in
More informationBile Duct Diseases and Problems
Bile Duct Diseases and Problems Introduction A bile duct is a tube that carries bile between the liver and gallbladder and the intestine. Bile is a substance made by the liver that helps with digestion.
More informationGluten Intolerance Basics
Gluten Intolerance Basics Schellenberg Chiropractic Inc. Dr. John Schellenberg 3445 Penrose Place Suite 260 Boulder, CO 80301 Gluten Intolerance Celiac Disease True Celiac Disease is a condition where
More informationPatterns of abnormal LFTs and their differential diagnosis
Patterns of abnormal LFTs and their differential diagnosis Professor Matthew Cramp South West Liver Unit and Peninsula Schools of Medicine and Dentistry, Plymouth Summary liver function / liver function
More informationInflammatory Bowel Disease
Inflammatory Bowel Disease Laboratory Support of Diagnosis and Management CLINICAL BACKGROUND Inflammatory bowel disease (IBD), which includes Crohn disease (CD) and ulcerative colitis (UC), is characterized
More informationSeriously, talk. tell. test. Celiac Disease.
Seriously, Celiac Disease. talk. If you have celiac disease, your family members might have it too. Talk to them about your experience and how celiac disease runs in families. Tell them the facts. Urge
More informationSubproject 4: Specification and Documentation of Metabolic and Neoplastic Diseases
Subproject 4: Specification and Documentation of Metabolic and Neoplastic Diseases M. Trauner, Division of Gastroenterology and Hepatology, Department of Internal Medicine, MUG Co- Investigator: H. Samonigg,
More informationEvaluation of abnormal LFT in the asymptomatic patient. Son Do, M.D. Advanced Gastroenterology Vancouver, WA
Evaluation of abnormal LFT in the asymptomatic patient Son Do, M.D. Advanced Gastroenterology Vancouver, WA Definition of chronic, abnormally elevated LFT Elevation of one or more of the following for
More information1.5 Function of analyte For albumin, see separate entry. The immunoglobulins are components of the humoral arm of the immune system.
Total protein (serum, plasma) 1 Name and description of analyte 1.1 Name of analyte Total protein 1.2 Alternative names None 1.3 NMLC code 1.4 Description of analyte This is a quantitative measurement
More informationEvaluation of Liver Function tests in Primary Care. Abid Suddle Institute of Liver Studies, KCH
Evaluation of Liver Function tests in Primary Care Abid Suddle Institute of Liver Studies, KCH Liver Function tests Markers of hepatocellular damage Cholestasis Liver synthetic function Markers of Hepatocellular
More informationThe ANA Test: All You Need to Know Department of Family and Community Medicine Family Medicine Update April 25, 2014
The ANA Test: All You Need to Know Department of Family and Community Medicine Family Medicine Update April 25, 2014 Celso R. Velázquez MD Division of Rheumatology University of Missouri velazquezc@health.missouri.edu
More informationP R O D U C T S CATALOG 2011-2012
P R O D U C T S CATALOG 2011-2012 INSTITUTE FOR THE APPLICATION OF NUCLEAR ENERGY - INEP Banatska 31b 11080 Zemun Belgrade Serbia Tel: (+381 11) 2619 252, 2618 696, 2199 949 Fax: (+381 11) 2618 724 www.inep.co.rs
More informationAmylase and Lipase Tests
Amylase and Lipase Tests Also known as: Amy Formal name: Amylase Related tests: Lipase The Test The blood amylase test is ordered, often along with a lipase test, to help diagnose and monitor acute or
More informationNP/PA Clinical Hepatology Fellowship Summary of Year-Long Curriculum
OVERVIEW OF THE FELLOWSHIP The goal of the AASLD NP/PA Fellowship is to provide a 1-year postgraduate hepatology training program for nurse practitioners and physician assistants in a clinical outpatient
More informationNew ESPGHAN guidelines for the diagnosis of Coeliac Disease in Children and Adolescents
New ESPGHAN guidelines for the diagnosis of Coeliac Disease in Children and Adolescents Steffen Husby Hans Christian Andersen Children s Hospital Odense University Hospital, Denmark Agenda Change in clinical
More informationBACKGROUND MEDIA INFORMATION Fast facts about liver disease
BACKGROUND MEDIA INFORMATION Fast facts about liver disease Liver, or hepatic, disease comprises a wide range of complex conditions that affect the liver. Liver diseases are extremely costly in terms of
More informationApproach to Abnormal Liver Tests
Approach to Abnormal Liver Tests Naga P. Chalasani, MD, FACG Professor of Medicine and Cellular & Integrative Physiology Director, Division of Gastroenterology and Hepatology Indiana University School
More informationFast Facts. Fast Facts: Liver Disorders. Thomas Mahl and John O Grady. 2006 Health Press Ltd. www.fastfacts.com
Fast Facts Fast Facts: Liver Disorders Thomas Mahl and John O Grady 2006 Health Press Ltd. www.fastfacts.com Fast Facts Fast Facts: Liver Disorders Thomas Mahl MD University at Buffalo School of Medicine
More informationAutoimmune pancreatitis. Lars Aabakken Oslo University Hospital - Rikshospitalet Oslo, Norway
Autoimmune pancreatitis Lars Aabakken Oslo University Hospital - Rikshospitalet Oslo, Norway Autoimmune pancreatitis Concept introduced in 1961 (Sarles) Re-invented in Japan 1995 (Yoshida) Increasingly
More informationAdams Memorial Hospital Decatur, Indiana EXPLANATION OF LABORATORY TESTS
Adams Memorial Hospital Decatur, Indiana EXPLANATION OF LABORATORY TESTS Your health is important to us! The test descriptions listed below are for educational purposes only. Laboratory test interpretation
More informationDIABETIC ENTEROPATHY: TWO. Gary L. Cornette, D.O., F.A.C.O.I Medical Director Gastroenterology
DIABETIC ENTEROPATHY: TWO DIFFICULT PROBLEMS DIAGNOSIS AND TREATMENT Gary L. Cornette, D.O., F.A.C.O.I Medical Director Gastroenterology Diabetic Enteropathy: What is it? Motility Disorders Esophageal
More informationHepatology Guidelines for Primary Care November 2011
Common requests for hepatology opinion/advice 1. Abnormal LFTs (is this fatty liver?) 2. Fatty Liver Disease (is this serious liver disease?) 3. Abnormal liver ultrasound 4. Alcohol related liver disease
More informationCorporate Medical Policy Genetic Testing for Alpha-1 Antitrypsin Deficiency
Corporate Medical Policy Genetic Testing for Alpha-1 Antitrypsin Deficiency File Name: Origination: Last CAP Review: Next CAP Review: Last Review: genetic_testing_for_alpha_1_antitrypsin_deficiency 5/2012
More information800-475-6473. www.sjogrens.org. www.sjogrens.org
S j ö g r e n s F a s t F a c t s l The hallmark symptoms of Sjögren s syndrome are dry eyes and dry mouth. l Sjögren s is one of the most prevalent autoimmune disorders, striking as many as 4,000,000
More informationQS114. NICE quality standard for irritable bowel syndrome in adults (QS114)
NICE quality standard for irritable bowel syndrome in adults (QS114) QS114 NICE approved the reproduction of its content for this booklet. The production of this booklet is sponsored by Thermo Fisher Scientific,
More informationThe EliA System Time for the essentials Cost efficient and flexible A boost in service for your laboratory and your clinicians
CCP The EliA System Time for the essentials completely automated (true walk-away, overnight runs) easy instrument management by Phadia Data Manager (IDM) software barcode-reader protocols, QC and raw data
More informationAnti-nuclear (ANA), anti-double stranded DNA (dsdna) and anti-extractable nuclear antigen (ENA) antibodies
Autoimmune testing The interpretation of all autoantibody tests is highly dependent on the likelihood of disease in the patient. The results should always be interpreted with the clinical features of the
More informationLiver Diseases. An Essential Guide for Nurses and Health Care Professionals
Brochure More information from http://www.researchandmarkets.com/reports/1047385/ Liver Diseases. An Essential Guide for Nurses and Health Care Professionals Description: Liver disease is a rapidly growing
More informationJuly 30, 2012. Probable Link Evaluation of Autoimmune Disease
1 July 30, 2012 Probable Link Evaluation of Autoimmune Disease Conclusion: On the basis of epidemiological and other data available to the C8 Science Panel, we conclude that there is a probable link between
More informationJump Start Your Gluten-Free Diet!
Jump Start Your Gluten-Free Diet! Living with Celiac/Coeliac Disease & Gluten Intolerance The University of Chicago Celiac Disease Center 1 BROUGHT TO YOU BY THE UNIVERSITY OF CHICAGO CELIAC DISEASE CENTER
More informationFood hypersensitivity and dietary intervention in diagnosis and therapy during the treatment of infertility and coexisting diseases Salt Lake City,
Food hypersensitivity and dietary intervention in diagnosis and therapy during the treatment of infertility and coexisting diseases Salt Lake City, USA, July 11 th, 2012 Maciej Barczentewicz, Magdalena
More informationUCLA Asian Liver Program
CLA Program Update Program Faculty Myron J. Tong, PhD, MD Professor of Medicine Hepatology Director, Asian Liver Program Surgery Ronald W. Busuttil, MD, PhD Executive Chair Department of Surgery Director,
More informationHepatitis C. Laboratory Tests and Hepatitis C
Hepatitis C Laboratory Tests and Hepatitis C If you have hepatitis C, your doctor will use laboratory tests to check your health. This handout will help you understand what the major tests are and what
More informationBritish Society of Gastroenterology (BSG) guidelines for management of autoimmune hepatitis
British Society of Gastroenterology (BSG) guidelines for management of autoimmune hepatitis Dermot Gleeson, 1 Michael A Heneghan 2 Guidelines 1 Liver Unit, Sheffield Teaching Hospitals Foundation Trust,
More informationThe child with abnormal liver function tests
The child with abnormal liver function tests Dr Jane Hartley Consultant Paediatric Hepatologist Birmingham Children s Hospital, UK 1 st Global Congress CIP, Paris 2011 Contents Over view of liver anatomy,
More informationProposal to Establish the Crohn s and Colitis Center at the University of Miami Miller School of Medicine
Proposal to Establish the Crohn s and Colitis Center at the University of Miami Miller School of Medicine Contents Mission... 1 Background... 2 Services and Programs... 2 Clinical Care... 2 IBD Specialists...
More informationPredicting and Preventing Autoimmunity, Myth or Reality?
Predicting and Preventing Autoimmunity, Myth or Reality? MICHAL HAREL a AND YEHUDA SHOENFELD a,b a Center for Autoimmune Diseases, Department of Medicine B, Chaim Sheba Medical Center Tel-Hashomer 52621,
More informationAbout Celiac Disease. A document providing answers and references to the most frequently asked questions about Celiac Disease
About Celiac Disease A document providing answers and references to the most frequently asked questions about Celiac Disease FAQ AboutCeliacDisease rev1 Basics What is Celiac Disease? Celiac Disease is
More informationZika Virus. Fred A. Lopez, MD, MACP Richard Vial Professor Department of Medicine Section of Infectious Diseases
Zika Virus Fred A. Lopez, MD, MACP Richard Vial Professor Department of Medicine Section of Infectious Diseases What is the incubation period for Zika virus infection? Unknown but likely to be several
More informationTumour Markers. What are Tumour Markers? How Are Tumour Markers Used?
Dr. Anthony C.H. YING What are? Tumour markers are substances that can be found in the body when cancer is present. They are usually found in the blood or urine. They can be products of cancer cells or
More informationCELIAC DISEASE A HIDDEN EPIDEMIC WORLDWIDE THE MOST UNDIAGNOSED AND MIS- DIAGNOSED AUTOIMMUNE DISEASE THE TIP OF THE ICEBURG
CELIAC DISEASE A HIDDEN EPIDEMIC WORLDWIDE THE MOST UNDIAGNOSED AND MIS- DIAGNOSED AUTOIMMUNE DISEASE THE TIP OF THE ICEBURG As a FCS professional, do YOU know the facts? Why do I care? Why should you
More informationProtein electrophoresis is used to categorize globulins into the following four categories:
Globulin Globulin is one of the two types of serum proteins, the other being albumin. This generic term encompasses a heterogeneous series of families of proteins, with larger molecules and less soluble
More information2.1 AST can be measured in heparin plasma or serum. 3 Summary of clinical applications and limitations of measurements
Aspartate aminotransferase (serum, plasma) 1 Name and description of analyte 1.1 Name of analyte Aspartate aminotransferase (AST) 1.2 Alternative names Systematic name L aspartate:2 oxoglutarate aminotransferase
More informationTo you, a member of the Swedish Society for Coeliacs,
To you, a member of the Swedish Society for Coeliacs Your experience is important! To you, a member of the Swedish Society for Coeliacs, We hope that you will spend some time helping us! We want to increase
More informationAlanine aminotransferase (serum, plasma)
Alanine aminotransferase (serum, plasma) 1 Name and description of analyte 1.1 Name of analyte Alanine aminotransferase (ALT) 1.2 Alternative names Systematic name L alanine:2 oxoglutarate aminotransferase
More informationHEPATOLOGY CLERKSHIP
College of Osteopathic Medicine HEPATOLOGY CLERKSHIP Office for Clinical Affairs 515-271-1629 FAX 515-271-1727 Elective Rotation General Description This elective rotation is a four (4) week introductory,
More informationBorrelia burgdorferi IgG, IgM Fully automated chemiluminescence assays for quantitative determination of Borrelia antibodies in serum and CSF
Borrelia burgdorferi IgG, IgM Fully automated chemiluminescence assays for quantitative determination of Borrelia antibodies in serum and FOR OUTSIDE THE US AND CANADA ONLY Borrelia burgdorferi IgG, IgM
More informationLIAISON XL HCV Ab Accurate diagnosis of the early stage of HCV infection
Hepatitis and Retrovirus LIAISON XL HCV Ab Accurate diagnosis of the early stage of HCV infection FOR OUTSIDE THE US AND CANADA ONLY LIAISON XL HCV Ab is Your solution LIAISON XL murex HCV Ab main features
More informationCorporate Medical Policy
Corporate Medical Policy Serum Biomarker Panel Testing for Systemic Lupus Erythematosus File Name: Origination: Last CAP Review: Next CAP Review: Last Review: serum_biomarker_panel_testing_for_systemic_lupus_erythematosus
More information190.33 - Hepatitis Panel/Acute Hepatitis Panel
190.33 - Hepatitis Panel/Acute Hepatitis Panel This panel consists of the following tests: Hepatitis A antibody (HAAb), IgM antibody; Hepatitis B core antibody (HBcAb), IgM antibody; Hepatitis B surface
More informationIndications in Hepatology and Liver Diseases
exclusively working in Health Care sananet GmbH Tilo Stolzke Breite Str. 6-8 23562 Lübeck Germany Telefon : +49 451 400 8301 Telefax : +49 451 400 8302 E-Mail : stolzke@sananet.com Internet : www.sananet.com
More informationIRON METABOLISM DISORDERS
IRON METABOLISM DISORDERS ANEMIA Definition Decrease in the number of circulating red blood cells Most common hematologic disorder by Most common hematologic disorder by far 1 Blood loss ANEMIA Causes
More informationPathophysiology of Diarrhea
1. Pathophysiology of Diarrhea 2. Case Presentation Page - 1 3. Diarrhea is the too rapid evacuation of too fluid sto... 4. The Amazing Intestines helsenet.info Page - 2 5. : Slide 5 6. Diarrhea helsenet.info
More informationAIR FORCE REPORTABLE EVENTS GUIDELINES & CASE DEFINITIONS
AIR FORCE REPORTABLE EVENTS GUIDELINES & CASE DEFINITIONS An Air Force addendum to the TRI-SERVICE REPORTABLE EVENTS GUIDELINES & CASE DEFINITIONS Prepared by: Air Force Institute for Operational Health
More informationAutoimmunity. Autoimmunity. Genetic Contributions to Autoimmunity. Targets of Autoimmunity
Autoimmunity Factors predisposing an individual to autoimmune disease Mechanisms of initiation of autoimmunity Pathogenesis of particular autoimmune disease Animal models of autoimmune disease Treatment
More informationBlood Testing Protocols. Disclaimer
Blood Testing Protocols / Page 2 Blood Testing Protocols Here are the specific test protocols recommend by Dr. J.E. Williams. You may request these from your doctor or visit www.readyourbloodtest.com to
More informationAutoimmunity and immunemediated. FOCiS. Lecture outline
1 Autoimmunity and immunemediated inflammatory diseases Abul K. Abbas, MD UCSF FOCiS 2 Lecture outline Pathogenesis of autoimmunity: why selftolerance fails Genetics of autoimmune diseases Therapeutic
More informationICD-9-CM/ICD-10-CM Codes for MNT
/ Codes for MNT ICD (International Classification of Diseases) codes are used by physicians and medical coders to assign medical diagnoses to individual patients. It is not within the scope of practice
More informationAlbumin. Prothrombin time. Total protein
Hepatitis C Fact Sheet February 2016 www.hepatitis.va.gov Laboratory Tests and Hepatitis If you have hepatitis C, your doctor will use laboratory tests to about learn more about your individual hepatitis
More informationDietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome
Dietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome Andrew T. Gewirtz et al N A T U R E VOL 519 5 M A R C H 2 0 1 5 Background Incidence of IBD Fact 1: increasing
More information190.25 - Alpha-fetoprotein
Other Names/Abbreviations AFP 190.25 - Alpha-fetoprotein Alpha-fetoprotein (AFP) is a polysaccharide found in some carcinomas. It is effective as a biochemical marker for monitoring the response of certain
More informationDevelopment and testing of an online training module on celiac disease for public school personnel
University of Tennessee, Knoxville Trace: Tennessee Research and Creative Exchange University of Tennessee Honors Thesis Projects University of Tennessee Honors Program 5-2012 Development and testing of
More informationMiscellaneous Genetic and Molecular Diagnostic Tests
Miscellaneous Genetic and Molecular Diagnostic Tests Policy Number: 2.04.121 Last Review: 3/2016 Origination: 12/2014 Next Review: 3/2017 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will
More informationThe most serious symptoms of this stage are:
The Natural Progression of Hepatitis C The natural history of hepatitis C looks at the likely outcomes for people infected with the virus if there is no medical intervention. However, the process of trying
More informationService Definition with all Clinical Terms Service: Laprascopic Cholecystectomy Clinic (No Gallstones in bile duct)
Service Definition with all Clinical Terms Service: Laprascopic Cholecystectomy Clinic (No Gallstones in bile duct) Section 1 Service Details Service ID: 7540540 Service Comments: Referrer Alert: Service
More informationEASL Clinical Practice Guidelines: Autoimmune hepatitis q
EASL Clinical Practice Guidelines: Autoimmune hepatitis q European Association for the Study of the Liver Introduction Autoimmune hepatitis (AIH) was the first liver disease for which an effective therapeutic
More informationLupus in Children and Teenagers. Arielle Hay, MD Pediatric Rheumatologist Nicklaus Children s Hospital
Lupus in Children and Teenagers Arielle Hay, MD Pediatric Rheumatologist Nicklaus Children s Hospital Systemic Lupus Erythematosus (SLE) Chronic Illness What is lupus? Autoimmune Multisystem Antinuclear
More informationEASL Clinical Practice Guidelines: Management of cholestatic liver diseases
Journal of Hepatology 51 (2009) 237 267 www.elsevier.com/locate/jhep EASL Clinical Practice Guidelines: Management of cholestatic liver diseases European Association for the Study of the Liver * Keywords:
More informationLyme (IgG and IgM) Antibody Confirmation
Pathology & Laboratory Medicine Lyme (IgG and IgM) Antibody Confirmation TEST UPDATE: New Test Notification Date: 1/9/2013 Effective Date: 1/7/2013 CONTACT INFO Call 802-847-5121 800-991-2799 email labmarketing@vtmednet.org
More informationProblems of the Digestive System
The American College of Obstetricians and Gynecologists f AQ FREQUENTLY ASKED QUESTIONS FAQ120 WOMEN S HEALTH Problems of the Digestive System What are some common digestive problems? What is constipation?
More informationCarbohydrate antigen 19 9 (CA 19 9) (serum, plasma)
Carbohydrate antigen 19 9 (CA 19 9) (serum, plasma) 1 Name and description of analyte 1.1 Name of analyte Carbohydrate antigen 19 9 (CA 19 9) 1.2 Alternative names Cancer antigen 19 9, cancer antigen GI
More informationRheumatoid Arthritis: Symptoms, Causes, and Treatments of Rheumatoid Foot and Ankle
Rheumatoid arthritis is the most common form of inflammatory arthritis, affecting about two to three million Americans. Rheumatoid arthritis is a symmetric disease, meaning that it will usually involve
More informationFocus Biobank Inflammatory Bowel Disease
Focus Biobank Inflammatory Bowel Disease University Hospitals Leuven KU Leuven Isabelle Cleynen, PhD Inflammatory Bowel Disease Crohn s disease (CD) Entire GI tract Transmural Fistulas and/or strictures
More informationAn Essential Guide to Recovery. Dr. Peter Osborne, D.C., D.A.C.B.N., PSc.D.
An Essential Guide to Recovery Dr. Peter Osborne, D.C., D.A.C.B.N., PSc.D. www.glutenfreesociety.org www.drpeterosborne.com Celiac Disease Rheumatoid Arthritis Bone Loss Osteoporosis Cancer (Lymphoma)
More informationRheumatoid Arthritis. Treating Inflammation. Sequoia Education Systems, Inc http://www.functionalmedicineuniversity.com 1. How is RA Diagnosed?
Rheumatoid Arthritis Causes, Assessment and Treatment How is RA Diagnosed? The following labs make up the basics of ruling in or out RA. Citrullinated Peptide (anti-ccp) Antibodies Rheumatoid factor Erythrocyte
More informationAsymptomatic Elevated Liver Function Tests: Physiology, Chemistry, and Workup
Asymptomatic Elevated Liver Function Tests: Physiology, Chemistry, and Workup James T. Sing, Jr., D.O., FACG, AGAF Scott & White Clinic Assistant Professor Department of Internal Medicine Division of Gastroenterology
More informationChronic Diarrhea in Children
Chronic Diarrhea in Children National Digestive Diseases Information Clearinghouse What is chronic diarrhea? Diarrhea is loose, watery stools. Chronic, or long lasting, diarrhea typically lasts for more
More informationThe Most Common Autoimmune Disease: Rheumatoid Arthritis. Bonita S. Libman, M.D.
The Most Common Autoimmune Disease: Rheumatoid Arthritis Bonita S. Libman, M.D. Disclosures Two googled comics The Normal Immune System Network of cells and proteins that work together Goal: protect against
More informationArthritis in Children: Juvenile Rheumatoid Arthritis By Kerry V. Cooke
Reading Comprehension Read the following essay on juvenile rheumatoid arthritis. Then use the information in the text to answer the questions that follow. Arthritis in Children: Juvenile Rheumatoid Arthritis
More informationStreptococcus pneumoniae IgG AB (13 Serotypes), MAID... 7
Volume 12 December 2011 Table of Contents Summary of Test Changes... 3 Test Changes... 6 Human Anti-Mouse AB (HAMA), ELISA... 6 Hepatitis E Antibody (IgG, IgM)... 6 Hepatitis E Antibody (IgG)... 6 Hepatitis
More informationSystemic Lupus Erythematosus
Harvard-MIT Division of Health Sciences and Technology HST.021: Musculoskeletal Pathophysiology, IAP 2006 Course Director: Dr. Dwight R. Robinson Systemic Lupus Erythematosus A multi-system autoimmune
More informationReconsideration Code 86386. Reconsideration Code Description Nuclear Matrix Protein 22 (NMP22), qualitative
Calendar Year 2013 Centers for Medicare and Medicaid Services (CMS) New and Reconsidered Clinical Laboratory Fee Schedule (CLFS) Test Codes And Final Payment Determinations Reconsideration Code 86386 Reconsideration
More informationchronic leukemia lymphoma myeloma differentiated 14 September 1999 Pre- Transformed Ig Surface Surface Secreted Myeloma Major malignant counterpart
Disease Usual phenotype acute leukemia precursor chronic leukemia lymphoma myeloma differentiated Pre- B-cell B-cell Transformed B-cell Plasma cell Ig Surface Surface Secreted Major malignant counterpart
More informationThe most common diseases caused by ingestion. Non-Celiac Gluten Sensitivity Where are We Now in 2015?
Carol Rees Parrish, M.S., R.D., Series Editor Non-Celiac Gluten Sensitivity Where are We Now in 2015? Anna Sapone Daniel A. Leffler Rupa Mukherjee Non-celiac gluten sensitivity (NCGS) is a term that is
More informationNational Medical Policy
National Medical Policy Subject: Policy Number: ANCA for Crohn s Disease and Ulcerative Colitis NMP187 Effective Date*: November 2004 Updated: April 2016 This National Medical Policy is subject to the
More informationBlood-Based Cancer Diagnostics
The Biotechnology Education Company Blood-Based Cancer Diagnostics EDVO-Kit 141 Store entire experiment at room temperature. EXPERIMENT OBJECTIVE: The objective of this experiment is to learn and understand
More informationThe Oxford IBD Service
Gastroenterology Unit, John Radcliffe Hospital The Oxford IBD Service Information for patients Information for patients 1 The Oxford Inflammatory Bowel Disease (IBD) Service Consultant Gastroenterologists
More informationDifferential Diagnosis
Differential Diagnosis Limited Scleroderma and Scleroderma-Like Disorders Morphea, or localized Scleroderma, usually begins between the ages of 20 to 50 years as patches of yellowish or ivory-colored rigid,
More information