Adaptive Returns of Deficient Systemic Plasma Immunoglobulin G Levels as Rehabilitation Biomarker After Emergency Colectomy for Fulminant Ulcerative Colitis

摘要: Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) is the standard surgical treatment for ulcerative colitis (UC). Emergency colectomies are performed fulminant (ie, toxic megacolon, profuse bleeding, perforation, or sepsis). The RPC and IPAA involve manipulation of proximal ileum, which may influence essential physiological function gut-associated lymphoid tissues. Circulating plasma immunoglobulin G (p-IgG) deficiency observed in patients UC. In addition, increased levels have been reported colonic tissues active UC compared quiescent disease. We aimed to examine p-IgG clinical evaluation following emergency disease having elective operations. total 45 received an ileoanal pouch (IAP) due all, 27 were men 18 women. mean age was 34 years (range: 18-55). Because UC, 26 had subtotal terminal ileostomy (TI). During second operation, rectum excised, IAP diverting loop (DLI) performed. Nineteen operations conjunction operation. Mucosectomy all groups. As a last procedure, DLI closed. Blood samples (IgG) analyses collected from each patient before colectomy, after colectomy TI (before construction pouch), during period pouches (prior closure), at 1, 2, 3 years 13.7 years 10-20) closure. Immunoglobulin determined by immunonephelometric assay technique. statistics analyzed analysis variance linear regression. Preoperatively, significantly lower who group that operations, 9.9 ± 3.0 vs 11.5 ± 3.3 g/L (P < .03). manipulative and/or DLI, both points, but increase not statistically significant (P = .26 P = .19). functional 10-20), there statistical (P < .002, P < .005, P < .0001) preoperative levels. These changes did correlate episodes pouchitis (P = .51). change preoperatively. After 12 months pouches, similar groups conclusion, found be surgery This difference probably losses impaired gut tissue production IgG acute phase closure, differences no longer between Restoration would exaggerated response make up precolectomy values interpreted as rehabilitation biomarker.