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pANCA and ASCA in Children with IBD-Unclassified, Crohn's Colitis, and Ulcerative Colitis-A Longitudinal Report from the IBD Porto Group of ESPGHAN

Birimberg-Schwartz, Liron ; Wilson, David C ; Kolho, Kaija-Leena ; Karolewska-Bochenek, Katarzyna ; Afzal, Nadeem Ahmad ; Spray, Christine ; Romano, Claudio ; Lionetti, Paolo ; Hauer, Almuthe C ; Martinez-Vinson, Christine ; Veres, Gabor ; Escher, Johanna C ; Turner, Dan

Inflammatory bowel diseases, 2016-08, Vol.22 (8), p.1908-1914 [Periódico revisado por pares]

England

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Título:
pANCA and ASCA in Children with IBD-Unclassified, Crohn's Colitis, and Ulcerative Colitis-A Longitudinal Report from the IBD Porto Group of ESPGHAN
Autor: Birimberg-Schwartz, Liron ; Wilson, David C ; Kolho, Kaija-Leena ; Karolewska-Bochenek, Katarzyna ; Afzal, Nadeem Ahmad ; Spray, Christine ; Romano, Claudio ; Lionetti, Paolo ; Hauer, Almuthe C ; Martinez-Vinson, Christine ; Veres, Gabor ; Escher, Johanna C ; Turner, Dan
Assuntos: 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
É parte de: Inflammatory bowel diseases, 2016-08, Vol.22 (8), p.1908-1914
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: 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.
Editor: England
Idioma: Inglês

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pANCA and ASCA in Children with IBD-Unclassified, Crohn's Colitis, and Ulcerative Colitis-A Longitudinal Report from the IBD Porto Group of ESPGHAN

Birimberg-Schwartz, Liron ; Wilson, David C ; Kolho, Kaija-Leena ; Karolewska-Bochenek, Katarzyna ; Afzal, Nadeem Ahmad ; Spray, Christine ; Romano, Claudio ; Lionetti, Paolo ; Hauer, Almuthe C ; Martinez-Vinson, Christine ; Veres, Gabor ; Escher, Johanna C ; Turner, Dan

England

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