title: Faecal alpha 1-antitrypsin concentration in the diagnosis and management of patients with pouchitis.
abstract: OBJECTIVE
  To investigate the role of faecal alpha 1-antitrypsin concentration in the diagnosis and management of patients with ileal pouch-anal anastomosis.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Fifty-two measurements of faecal alpha 1-antitrypsin concentration were taken from 33 patients operated on for ulcerative colitis.
  
  
  RESULTS
  Patients with active pouchitis (44.4 +/- 7.1 mg%) had a three-fold higher mean faecal alpha 1-antitrypsin concentration than patients in remission (13.7 +/- 1.3 mg%; P < 0.0001), than patients who had never had pouchitis (14.4 +/- 2.3 mg%; P < 0.003) and than patients with incontinent ileostomies (12.7 +/- 1.3 mg%; P < 0.004). Faecal alpha 1-antitrypsin measurements were 80% sensitive and 97% specific for active pouchitis. A significant positive correlation between the pouchitis disease activity index and faecal protein loss was observed (r = 0.702; P < 0.0001). The correlations between protein loss and other parameters were weaker (protein loss versus clinical score, r = 0.309; versus endoscopic score, r = 0.583; and versus histologic score, r = 0.558).
  
  
  CONCLUSIONS
  Faecal alpha 1-antitrypsin concentration is a good indicator of the degree of intestinal inflammation in pouchitis and may be useful as a quantitative index of disease activity in prospective studies.
authors.affiliation: Department of Gastroenterology, Hospital of Gastroenterology, Bonorino Udaondo, Buenos Aires, Argentina.
authors.forename: L A
authors.initials: LA
authors.lastname: Boerr
authors.forename: A M
authors.initials: AM
authors.lastname: Sambuelli
authors.forename: E
authors.initials: E
authors.lastname: Sugai
authors.forename: A
authors.initials: A
authors.lastname: Graziano
authors.forename: J
authors.initials: J
authors.lastname: Valero
authors.forename: Z
authors.initials: Z
authors.lastname: Kogan
authors.forename: J
authors.initials: J
authors.lastname: Bai
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis*; D003093:Colitis, Ulcerative / Q000601:surgery; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D016737:Proctocolectomy, Restorative; D011446:Prospective Studies; D011504:Protein-Losing Enteropathies / Q000175:diagnosis; D012680:Sensitivity and Specificity; D000515:alpha 1-Antitrypsin / Q000032:analysis*
chemical_list: D015415:Biomarkers; D000515:alpha 1-Antitrypsin