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World J Gastroenterol. 2019 Apr 14;25(14):1753-1763. doi: 10.3748/wjg.v25.i14.1753.

Measurement of prostaglandin metabolites is useful in diagnosis of small bowel ulcerations.

Author information

1
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
2
Department of Endoscopic Diagnostics and Therapeutic, Saga University Hospital, Saga 849-8501, Japan.
3
Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino 818-8502, Japan.
4
Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8586, Japan.
5
Department of Intestinal Inflammation Research, Hyogo College of Medicine, Nishinomiya 663-8501, Japan.
6
Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo 160-0016, Japan.
7
the Third Department of Internal Medicine, Kyorin University School of Medicine, Mitaka 181-8611, Japan.
8
Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Morioka 020-8505, Japan.
9
Division of Gastroenterology, Matsuyama Red Cross Hospital, Matsuyama 790-8524, Japan.
10
Department of Gastroenterology, Sada Hospital, Fukuoka 810-0004, Japan.
11
Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Morioka 020-8505, Japan. tmatsumo@iwate-med.ac.jp.

Abstract

BACKGROUND:

We recently reported on a hereditary enteropathy associated with a gene encoding a prostaglandin transporter and referred to as chronic enteropathy associated with SLCO2A1 gene (CEAS). Crohn's disease (CD) is a major differential diagnosis of CEAS, because these diseases share some clinical features. Therefore, there is a need to develop a convenient screening test to distinguish CEAS from CD.

AIM:

To examine whether prostaglandin E major urinary metabolites (PGE-MUM) can serve as a biomarker to distinguish CEAS from CD.

METHODS:

This was a transactional study of 20 patients with CEAS and 98 patients with CD. CEAS was diagnosed by the confirmation of homozygous or compound heterozygous mutation of SLCO2A1. We measured the concentration of PGE-MUM in spot urine by radioimmunoassay, and the concentration was compared between the two groups of patients. We also determined the optimal cut-off value of PGE-MUM to distinguish CEAS from CD by receiver operating characteristic (ROC) curve analysis.

RESULTS:

Twenty Japanese patients with CEAS and 98 patients with CD were enrolled. PGE-MUM concentration in patients with CEAS was significantly higher than that in patients with CD (median 102.7 vs 27.9 μg/g × Cre, P < 0.0001). One log unit increase in PGE-MUM contributed to 7.3 increase in the likelihood for the diagnosis of CEAS [95% confidence interval (CI) 3.2-16.7]. A logistic regression analysis revealed that the association was significant even after adjusting confounding factors (adjusted odds ratio 29.6, 95%CI 4.7-185.7). ROC curve analysis revealed the optimal PGE-MUM cut-off value for the distinction of CEAS from CD to be 48.9 μg/g × Cre with 95.0% sensitivity and 79.6% specificity.

CONCLUSION:

PGE-MUM measurement is a convenient, non-invasive and useful test for the distinction of CEAS from CD.

KEYWORDS:

Chronic enteropathy associated with SLCO2A1 gene; Chronic nonspecific multiple ulcers of the small intestine; Crohn’s disease; Prostaglandin E major urinary metabolites; Small intestine

PMID:
31011259
PMCID:
PMC6465938
DOI:
10.3748/wjg.v25.i14.1753
[Indexed for MEDLINE]
Free PMC Article

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