Inflammatory Bowel Disease

Comprehensive testing for differentiation, diagnosis, and therapeutic monitoring.

Calprotectin

First Line IBD & IBS Differentiation

Calprotectin is a noninvasive, first-line test in the diagnostic differentiation of inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) and it may eliminate the need for additional costly and invasive procedures. When used for this initial, differential diagnosis, fecal calprotectin has a sensitivity and specificity of approximately 85 percent.

Thiopurine Testing

Optimize Therapeutic Outcomes

Thiopurines are widely known as an effective treatment for patients with inflammatory bowel disease. However, a significant portion of these patients display individual variations in thiopurine metabolism resulting in an increased risk for adverse reactions and/or a sub-optimal therapeutic response.

Mayo Clinic Laboratories now offers end-to-end thiopurine testing services that will provide you with the support needed to optimize therapeutic outcomes.

Biologic Therapies

Reflexive Approaches to Optimize Treatment for IBD

Many patients may have flare-ups of their disease, or they may stop responding to treatment. In these situations, the clinician may choose to increase the dose administered or recommend more frequent injections. One cause of decreased response to treatment is the appearance of anti-drug antibodies or “immunogenicity.”

To monitor for immunogenicity, our reflexive approach first measures the biologic concentration within a patient’s specimen. Then, if necessary, an additional test is performed to assess the presence of antibodies to a specific drug that the patient has been receiving.

Monogenic IBD

A Distinct Classification Provides Actionable Answers

Monogenic inflammatory bowel disease (IBD) refers to a diverse spectrum of rare genetic disorders that present with intestinal inflammation. The majority of patients with monogenic IBD, unlike those with polygenic IBD, show symptoms before the age of six. Additionally, because monogenic and polygenic IBD can have indistinguishable endoscopic or histologic features, establishing an accurate diagnosis via traditional methods remains a challenge.

Resources

NUDT15: An additional gene important in prediction of thiopurine-related toxicity

The thiopurine drugs are purine antimetabolites that are useful in the treatment of acute lymphoblastic leukemia, autoimmune disorders (e.g., Crohn disease, rheumatoid arthritis), and organ transplant recipients.

Signs that should raise suspicion of monogenic IBD and prompt testing

Monogenic inflammatory bowel disease (IBD) refers to a diverse spectrum of rare genetic disorders that present with intestinal inflammation. The majority of patients with monogenic IBD, unlike those with polygenic IBD, show symptoms before the age of six. 

A Test in Focus: TPMT testing in the treatment of Inflammatory Bowel Disease.

Our testing is validated and developed through the use of in-house clinical studies. We also reference publications and research in each of our reports to provide clinical evidence to our interpretations.

Intestinal Infections

A multiplex PCR test capable of qualitatively detecting DNA or RNA of 22 pathogens in approximately one hour.

GI Pathogens

Rapid multiplex panel detection of the most common agents of bacterial, viral, and parasitic enteric infections is sensitive, specific, and provides same-day results, obviating the need for culture, antigen testing, microscopy, or individual nucleic acid amplification tests.

Liver Diseases

Comprehensive testing developed by clinical experts to determine the underlying cause and rule out other causes for the disease.

NASH

Confidently evaluate for NASH, Steatosis, and Fibrosis/Cirrhosis with one standard blood sample

Using a simple blood sample, this test combines 10 standard biomarkers into 5 scores to provide a complete assessment of the condition of the liver and the 5 main causes of liver disease including: Hepatic steatosis, NASH, alcoholic steatohepatitis, fibrosis, and liver inflammation.

Viral Hepatitis

An Algorithmic Approach to Testing for Diagnosis and Treatment

Hepatitis is a disease characterized by inflammation of the liver. Infection with a virus is a common cause of hepatitis and may be acute or chronic depending on the virus.

Several laboratory tests may be performed in cases of known or suspected viral hepatitis to help diagnose and monitor patients. At Mayo Clinic, we utilize an algorithmic approach to testing that takes the guesswork out of test ordering to focus on proper test utilization, saving your institution time and money.

Genetic Liver Disease

Testing for Early Identification of Underlying Cause to Prevent Organ Damage

Identifying underlying genetic disorders plays an important role in the treatment and care of patients with liver disease. Appropriate use of screening tests in routine clinical practice can rule out possible causes of liver disease and assist in early identification and treatment of genetic liver diseases to prevent terminal organ damage.

Autoimmune Liver Disease

Antibody Testing for Early and Accurate Diagnosis

Due to the variance in autoimmune disease forms (which include autoimmune hepatitis [AIH], primary biliary cirrhosis [PBC], and primary sclerosing cholangitis [PSC]), many patients can be misdiagnosed. Our panel evaluates smooth muscle antibodies (SMA), antinuclear antibodies (ANA), and antimitochondrial antibodies (AMA) for patients with suspected autoimmune liver disease, specifically type 1 AIH or PBC.

Autoimmune Disorders

Definitive diagnoses and significant cost reduction through reflexive testing.

Autoimmune GI Dysmotility

Targeted Evaluations for Idiopathic GI Motility Disorders

Autoimmune gastrointestinal dysmotility (AGID) is a limited manifestation of autoimmune dysautonomia that occurs as an idiopathic phenomenon. Signs and symptoms include early satiety, nausea, vomiting, bloating, diarrhea, constipation, and involuntary weight loss. The onset may be subacute, and neurological manifestations may or may not be an accompaniment.

Identifying GI dysmotility as autoimmune-mediated is extremely important because patients treated with immunotherapy can see a dramatic improvement, going from persistent nausea, vomiting, and weight
loss to feeling normal within a few weeks.

Celiac Disease

Testing to Aid in a Challenging Diagnosis

Working closely with our clinical GI colleagues, we have established several cascading algorithms to aid in the diagnosis of celiac disease. These algorithms, each with a specific utility, use automatic reflexing to perform the necessary tests and are available as orderable clinical tests.

Pancreatic Diseases

Genetic Testing to confirmation of suspected clinical diagnosis of familial or hereditary pancreatitis

Hereditary Pancreatitis

Hereditary pancreatitis (HP) is defined as 2 or more individuals in a family affected with pancreatitis involving at least 2 generations. Mutations in several genes, including PRSS1, CFTR, CTRC, and SPINK1 have demonstrated genetic susceptibility to chronic pancreatitis. 

Genetic testing can confirm suspected clinical diagnosis of familial or hereditary pancreatitis in patients with chronic pancreatitis, identify gene mutations contributing to pancreatitis in an individual family, and allow for predictive and diagnostic testing in family members.

HPPAN | Hereditary Pancreatitis Panel