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Dig Dis Sci. 2010 Aug;55(8):2309-15. doi: 10.1007/s10620-009-0998-7. Epub 2009 Oct 14.

Diagnostic role and clinical association of ASCA and ANCA in Brazilian patients with inflammatory bowel disease.

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  • 1Laboratory of Immunopathology, Federal University of ParanĂ¡, Curitiba, PR, Brazil. renatomitsu@yahoo.com.br

Abstract

BACKGROUND:

Anti-Saccharomyces cerevisae antibody (ASCA) and perinuclear anti-neutrophil cytoplasmatic antibody (pANCA) remain the most well-established markers in inflammatory bowel disease (IBD), and both may be associated with disease phenotype.

AIM:

To determine the utility of ASCA and pANCA as markers in a Brazilian cohort of IBD patients.

MATERIALS AND METHODS:

A total of 90 patients with ulcerative colitis (UC), 77 patients with Crohn's disease (CD), and 57 healthy individuals were included in the study. ASCA was determined by enzyme-linked immunosorbent assay (ELISA) and pANCA by immunofluorescence assay.

RESULTS:

In support of diagnosis of UC, the sensitivity and specificity of pANCA were 51% and 100%, respectively. ASCA (IgA or IgG isotypes) presented sensitivity of 62% and specificity of 93% for CD. The combination of ASCA negativity and pANCA positivity (ASCA-/pANCA+) displayed sensitivity of 43% and specificity of 100% for diagnosis to UC. In CD patients, ASCA+/pANCA- presented sensitivity and specificity of 57% and 93%, respectively. Additionally, ASCA positivity correlated with early age at disease onset and ileal location in CD patients. In UC patients, pANCA positivity was correlated with pancolitis or left colitis.

CONCLUSIONS:

The results evidenced that low sensitivity of ASCA and pANCA markers limits their use in IBD screening in the general population; however, their specificity may contribute to differentiation between CD and UC in IBD patients. Our study lends further support to the suggestion that serologic assessment identifies different subtypes of IBD.

PMID:
19826949
[PubMed - indexed for MEDLINE]
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