Abstract

Serum samples from 83 patients (42 women, 41 men, mean age 41 [19-85] years) with chronic inflammatory bowel diseases (ulcerative colitis: n = 41, Crohn's disease: n = 42) of differing degrees of activity were tested for antineutrophil cytoplasmic antibodies (ANCA) by immunofluorescence microscopy and various ELISA techniques. Seven patients with ulcerative colitis and one with Crohn's disease were suffering from associated primary sclerosing cholangitis. ANCA were detected in 18 sera, 13 from patients with ulcerative colitis (31.7%) and five from patients with Crohn's disease (11.9%). Six of the eight patients with primary sclerosing cholangitis were ANCA-positive. Nine sera showed a cytoplasmic (c-ANCA-) pattern and 9 others showed a partially atypical perinuclear (p-ANCA-) pattern. Among the ANCA-positive sera, ELISA techniques showed that two had antibodies against serine proteinase 3, two against lactoferrin, two against elastase and one against myeloperoxidase. There was no correlation between the anatomical pattern or activity of the disease and the presence of ANCA. The antineutrophil cytoplasm antibodies demonstrable in chronic inflammatory bowel disease appear to be directed against so far unknown antigens. They are particularly frequent in patients with associated primary sclerosing cholangitis.