High level perinuclear antineutrophil cytoplasmic antibody (pANCA) in ulcerative colitis patients before colectomy predicts the development of chronic pouchitis after ileal pouch-anal anastomosis
作者： P R Fleshner
DOI: 10.1136/GUT.49.5.671
关键词:
摘要: BACKGROUND The reported cumulative risk of developing pouchitis in ulcerative colitis (UC) patients undergoing ileal pouch-anal anastomosis (IPAA) approaches 50% after 10 years. To date, no preoperative serological predictor has been found. AIMS assess whether perinuclear antineutrophil cytoplasmic antibody (pANCA) expression was associated with acute and/or chronic IPAA. METHODS Patients were prospectively assessed for the development clinically and endoscopically proved pouchitis. Serum obtained at time colectomy 95 UC IPAA analysed pANCA by ELISA indirect immunofluorescence. pANCA+ stratified into high level (>100 units (EU)/ml) (n=9), moderate (40–100 EU/ml) (n=32), low ( RESULTS Sixty (63%) expressed pANCA. After a median follow up 32 months (range 1–89), (34%) developed either (n=14) or (n=18) Pouchitis seen 42% compared 20% pANCA− (p=0.09). There significant difference incidence between three patient subgroups. among (56%) before significantly higher than medium (22%), (16%), those who (20%) (p = 0.005). Multivariate analysis revealed that sole parameter presence (p=0.005). CONCLUSION High is
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