Erhan TATAR, Cem ÇEKİÇ, Serkan İPEK, Sezgin VATANSEVER, Serdal DEMİR, Firdevs TOPAL, Dilek SOYSAL ERSİL, Belkıs ÜNSAL

Anti-pankreatik antikor, anti-nötrofil sitoplazmik antikor ve anti- Saccharomyces cerevisiae antikorlarının inflamatuvar barsak hastalıklarındaki tanısal değeri ve hastalık aktivitesi ile ilişkilerinin değerlendirilmesi

Giriş ve Amaç: İnflamatuvar barsak hastalığı ile ilişkili oldukça fazla serolojik belirteç tanımlansa da klinik sonuçları etkileyen kanıtlar sınır- lıdır. Bu çalışmada anti-pankreatik antikor, p-ANCA ve ASCAnın infla - matuvar barsak hastalığının ayırıcı tanısındaki yeri ve hastalık aktivitesi ile antikorlar arasındaki ilişkinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: İnflamatuvar barsak hastalığı tanılı 95 hasta (63 ülseratif kolit, 29 Crohn hastası, 3 indetermine kolit) ve 65 sağlıklı kontrolden alınan serum örneklerinden indirekt immunofluorosan yöntemi ile oto- antikor varlığı araştırıldı. Bulgular: Anti-pankreatik antikor sıklığı, Cro- hn hastalığında %6,9 (2/29), ülseratif kolitte %3,2 (2/63) olarak sap- tandı. İndetermine kolit ve kontrol grubunda anti-pankreatik antikor tespit edilmedi. Ülseratif kolit ve Crohn hastalığı arasında anti-pankre - atik antikor sıklığı açısından istatistiksel olarak anlamlı fark bulunmadı. p-ANCA sıklığı, ülseratif kolitte %46 (29/63), Crohn hastalığında %13,8 (4/29), indetermine kolitte %66,6 (2/3), kontrol grubunda %4,6 (3/65) olarak bulundu. p-ANCA sıklığının ülseratif kolitte, Crohn hastalığına göre istatistiksel olarak anlamlı olduğu saptandı. ASCA sıklığı Crohn hastalığında %34,5 (10/29), ülseratif kolit hastalarında %7,9 (5/63), kontrol grubunda %3,1 (2/65) olarak bulundu. İndetermine kolit olgu- larında ASCA saptanmadı. ASCA sıklığının Crohn hastalığında, ülseratif kolite göre istatistiksel olarak anlamlı olduğu görüldü. Anti-pankreatik antikor, p-ANCA ve ASCA varlığının inflamatuvar barsak hastalığında hastalık aktivitesi ile ilişkili olmadığı tespit edildi. Sonuç: Anti-pankrea - tik antikorun inflamatuvar barsak hastalığı ile ilişkili olabileceği ancak ayırıcı tanısında tek başına yeterli olamayacağı sonucuna varılabilir. ASCA ve p-ANCAnın inflamatuvar barsak hastalığı ayırıcı tanısında yar- dımcı testler olarak kullanılabileceği, anti-pankreatik antikor için daha fazla çalışmaya ihtiyaç olduğu söylenebilir.

Evaluation of diagnostic values of anti-pancreatic antibody, anti-neutrophil cytoplasmic antibody (p-ANCA) and anti-Saccharomyces cerevisiae antibody (ASCA) in inflammatory bowel disease and their association with disease activity

Background and Aims: Although many serological markers associat- ed with inflammatory bowel disease have been defined, the evidence that interacts with clinical results is limited. We aimed to evaluate the relevance of anti-pancreatic antibody, p-ANCA and ASCA in the dif- ferential diagnosis of inflammatory bowel disease and their correlation with disease activity. Materials and Methods: The presence of anti- pancreatic antibody, p-ANCA and ASCA was determined in indirect immunofluorescence assay of serum samples from 95 patients with inflammatory bowel disease (63 ulcerative colitis, 29 Crohns disease, 3 indeterminate colitis) and 65 healthy controls. Results: Anti-pancre - atic antibody was present in 6,9% (2/29) in Crohns disease and 3,2% (2/63) in ulcerative colitis. Anti-pancreatic antibody was not detected in the indeterminate colitis and control groups. No statistical differ- ence was found between ulcerative colitis and Crohns disease in terms of anti-pancreatic antibody incidence. p-ANCA was detected in 46% (29/63) in ulcerative colitis, 13,8% (4/29) in Crohns disease, 66,6% (2/3) in indeterminate colitis, and 4,6% (3/65) in the control group. p- ANCA was statistically higher in ulcerative colitis compared to Crohns disease. ASCA was present in 34,5% (10/29) in Crohns disease, 7,9% (5/63) in ulcerative colitis and 3,1% (2/65) in the control group. ASCA was not detected in the patients with indeterminate colitis. ASCA was statistically higher in Crohns disease compared to ulcerative colitis. It was found that anti-pancreatic antibody, p-ANCA and ASCA were not associated with disease activity in inflammatory bowel disease. Conclusions: We may conclude that anti-pancreatic antibody can be associated with inflammatory bowel disease, but it is not sufficient by itself for the differential diagnosis of inflammatory bowel disease. ASCA and p-ANCA may be helpful tools in the differential diagnosis of inflammatory bowel disease, but more studies are warranted for anti- pancreatic antibody.

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