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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Birimberg-Schwartz, L; Wilson, DC; Kolho, KL; Karolewska-Bochenek, K; Afzal, NA; Spray, C; Romano, C; Lionetti, P; Hauer, AC; Martinez-Vinson, C; Veres, G; Escher, JC; Turner, D; paediatric IBD Porto group of ESPGHAN.
pANCA and ASCA in Children with IBD-Unclassified, Crohn's Colitis, and Ulcerative Colitis-A Longitudinal Report from the IBD Porto Group of ESPGHAN.
Inflamm Bowel Dis. 2016; 22(8):1908-1914 Doi: 10.1097/MIB.0000000000000784 [OPEN ACCESS]
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Hauer Almuthe

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No study to date has evaluated perinuclear antineutrophil cytoplasmic antibody (pANCA) and anti-Saccharomyces cerevisiae antibody (ASCA) in pediatric inflammatory bowel disease-unclassified (IBDU) as compared with Crohn's colitis (CC) and ulcerative colitis (UC), which represent the diagnostic challenge. We aimed to explore the diagnostic utility of serology and to assess whether serology can predict disease severity in these subgroups. This was a multicenter retrospective longitudinal study including 406 children with inflammatory bowel diseases (IBD) from 23 centers affiliated with the Porto group of European Society of Pediatric Gastroenterology, Hepatology and Nutrition (mean age 10.5 ± 3.9, 54% males); 117 (29%) with CC, 143 (35%) with UC, and 146 (36%) with IBDU. Median follow-up period was 2.8 years (interquartile range, 1.6-4.2). The most prevalent serologic profile in IBDU was pANCA-/ASCA- (41%), followed by pANCA+/ASCA- (34%) and pANCA-/ASCA+ (17%). pANCA-/ASCA+ differentiated well between CC versus IBDU (83% specificity, 96% positive predictive value [PPV]) and UC (97% specificity, 90% PPV) patients, albeit with a low negative predictive value (13% and 40%, respectively). pANCA+/ASCA- did not differentiate as well between IBD subgroups, but UC children with pANCA+/ASCA- had more often severe disease at diagnosis (36 [62%] versus 22 [38%], P = 0.033) and needed more often calcineurin inhibitors, biologics, or colectomy (25 [80%] versus 6 [20%], P = 0.026). In CC, double positivity for ASCA and not pANCA-/ASCA+ profile was associated with disease severity. Serology may have some role in predicting disease course and outcomes in colonic IBD, but its routine use needs to be supported by more studies. Serology cannot routinely be recommended for differentiating between IBDU versus CC or UC as a sole diagnostic criterion given its low diagnostic utility.
Find related publications in this database (using NLM MeSH Indexing)
Adolescent -
Antibodies, Antineutrophil Cytoplasmic - blood
Antibodies, Bacterial - blood
Biological Products - therapeutic use
Calcineurin Inhibitors - therapeutic use
Child -
Child, Preschool -
Colitis, Ulcerative - blood
Colitis, Ulcerative - diagnosis
Colitis, Ulcerative - drug therapy
Crohn Disease - blood
Crohn Disease - diagnosis
Crohn Disease - drug therapy
Diagnosis, Differential -
Female -
Humans -
Inflammatory Bowel Diseases - blood
Inflammatory Bowel Diseases - diagnosis
Longitudinal Studies -
Male -
Predictive Value of Tests -
Retrospective Studies -
Saccharomyces cerevisiae - immunology
Severity of Illness Index -

Find related publications in this database (Keywords)
Crohn's colitis
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