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The value of serologic markers in indeterminate colitis : a prospective follow-up study

S Joossens, W Reinisch, S Vermeire, B Sendid, D Poulain, Marc Peeters UGent, K Geboes, X Bossuyt, P Vandewalle, G Oberhuber, et al. (2002) GASTROENTEROLOGY. 122(5). p.1242-1247
abstract
Background & Aims: In the absence of pathognomonic markers for Crohn's disease (CD) and ulcerative colitis (UC), the diagnosis of inflammatory bowel disease depends on a compendium of clinical, radiographic, endoscopic, and histologic criteria that bears imperfect specificity to the individual disorders. In 10% of cases of colitis, no differentiation can be made between CD and UC; these patients are diagnosed with indeterminate colitis (IC). We evaluated the value of anti-Saccharomyces cerevisiae antibodies (ASCA) and perinuclear antineutrophil cytoplasmic antibodies (pANCA) to increase diagnostic accuracy in categorizing IC. Methods: Since 1996, 97 patients with IC from 3 centers (Leuven, Lille, and Vienna) were enrolled, analyzed for pANCA and ASCA, and followed up prospectively. Results: A definitive diagnosis has been reached for 3:1 of 97 patients (32%). In these patients, ASCA+/pANCA- correlated with CD in 8 of :10 patients, whereas ASCA-/pANCA+ correlated with UC in 7 of 11 patients. The remaining 4 cases became CD, clinically behaving as UC-like CD. Almost half of the patients (47 of 97 [48.5%]) were negative for ASCA and pANCA, and 40 remain diagnosed with IC to date. Only 7 seronegative cases (14.9%) became CD or UC compared with 48% (24 of 50) of seropositive patients (P < 0.001). Conclusions: Results so far show that ASCA+/pANCA- predicts CD in 80% of patients with IC and ASCA-/pANCA+ predicts UC in 63.6%. Interestingly, 48.5% of patients do not show antibodies against ASCA or pANCA. Most of these patients remain diagnosed with IC during their further clinical course, perhaps reflecting a distinct clinicoserological entity.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
INFLAMMATORY-BOWEL-DISEASE, ANTINEUTROPHIL CYTOPLASMIC AUTOANTIBODIES, ANTI-SACCHAROMYCES CEREVISIAE, ULCERATIVE-COLITIS, CROHNS-DISEASE, DIFFERENTIAL-DIAGNOSIS, OF-GASTROENTEROLOGY, CLINICAL EVOLUTION, BIOPSY DIAGNOSIS, ANTIBODIES
journal title
GASTROENTEROLOGY
Gastroenterology
volume
122
issue
5
pages
1242 - 1247
Web of Science type
Article
Web of Science id
000175305500009
JCR category
GASTROENTEROLOGY & HEPATOLOGY
JCR impact factor
13.44 (2002)
JCR rank
1/45 (2002)
JCR quartile
1 (2002)
ISSN
0016-5085
DOI
10.1053/gast.2002.32980
language
English
UGent publication?
yes
classification
A1
id
164630
handle
http://hdl.handle.net/1854/LU-164630
date created
2004-01-14 13:40:00
date last changed
2017-10-17 10:33:56
@article{164630,
  abstract     = {Background \& Aims: In the absence of pathognomonic markers for Crohn's disease (CD) and ulcerative colitis (UC), the diagnosis of inflammatory bowel disease depends on a compendium of clinical, radiographic, endoscopic, and histologic criteria that bears imperfect specificity to the individual disorders. In 10\% of cases of colitis, no differentiation can be made between CD and UC; these patients are diagnosed with indeterminate colitis (IC). We evaluated the value of anti-Saccharomyces cerevisiae antibodies (ASCA) and perinuclear antineutrophil cytoplasmic antibodies (pANCA) to increase diagnostic accuracy in categorizing IC.
Methods: Since 1996, 97 patients with IC from 3 centers (Leuven, Lille, and Vienna) were enrolled, analyzed for pANCA and ASCA, and followed up prospectively.
Results: A definitive diagnosis has been reached for 3:1 of 97 patients (32\%). In these patients, ASCA+/pANCA- correlated with CD in 8 of :10 patients, whereas ASCA-/pANCA+ correlated with UC in 7 of 11 patients. The remaining 4 cases became CD, clinically behaving as UC-like CD. Almost half of the patients (47 of 97 [48.5\%]) were negative for ASCA and pANCA, and 40 remain diagnosed with IC to date. Only 7 seronegative cases (14.9\%) became CD or UC compared with 48\% (24 of 50) of seropositive patients (P {\textlangle} 0.001).
Conclusions: Results so far show that ASCA+/pANCA- predicts CD in 80\% of patients with IC and ASCA-/pANCA+ predicts UC in 63.6\%. Interestingly, 48.5\% of patients do not show antibodies against ASCA or pANCA. Most of these patients remain diagnosed with IC during their further clinical course, perhaps reflecting a distinct clinicoserological entity.},
  author       = {Joossens, S and Reinisch, W and Vermeire, S and Sendid, B and Poulain, D and Peeters, Marc and Geboes, K and Bossuyt, X and Vandewalle, P and Oberhuber, G and Vogelsang, H and Rutgeerts, P and Colombel, JF},
  issn         = {0016-5085},
  journal      = {GASTROENTEROLOGY},
  keyword      = {INFLAMMATORY-BOWEL-DISEASE,ANTINEUTROPHIL CYTOPLASMIC AUTOANTIBODIES,ANTI-SACCHAROMYCES CEREVISIAE,ULCERATIVE-COLITIS,CROHNS-DISEASE,DIFFERENTIAL-DIAGNOSIS,OF-GASTROENTEROLOGY,CLINICAL EVOLUTION,BIOPSY DIAGNOSIS,ANTIBODIES},
  language     = {eng},
  number       = {5},
  pages        = {1242--1247},
  title        = {The value of serologic markers in indeterminate colitis : a prospective follow-up study},
  url          = {http://dx.doi.org/10.1053/gast.2002.32980},
  volume       = {122},
  year         = {2002},
}

Chicago
Joossens, S, W Reinisch, S Vermeire, B Sendid, D Poulain, Marc Peeters, K Geboes, et al. 2002. “The Value of Serologic Markers in Indeterminate Colitis : a Prospective Follow-up Study.” Gastroenterology 122 (5): 1242–1247.
APA
Joossens, S., Reinisch, W., Vermeire, S., Sendid, B., Poulain, D., Peeters, M., Geboes, K., et al. (2002). The value of serologic markers in indeterminate colitis : a prospective follow-up study. GASTROENTEROLOGY, 122(5), 1242–1247.
Vancouver
1.
Joossens S, Reinisch W, Vermeire S, Sendid B, Poulain D, Peeters M, et al. The value of serologic markers in indeterminate colitis : a prospective follow-up study. GASTROENTEROLOGY. 2002;122(5):1242–7.
MLA
Joossens, S, W Reinisch, S Vermeire, et al. “The Value of Serologic Markers in Indeterminate Colitis : a Prospective Follow-up Study.” GASTROENTEROLOGY 122.5 (2002): 1242–1247. Print.