Faecal alpha 1-antitrypsin concentration in the diagnosis and management of patients with pouchitis.
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.
Boerr
L A
LA
Department of Gastroenterology, Hospital of Gastroenterology, Bonorino Udaondo, Buenos Aires, Argentina.
Sambuelli
A M
AM
Sugai
E
E
Graziano
A
A
Valero
J
J
Kogan
Z
Z
Bai
J
J
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*
D015415:Biomarkers; D000515:alpha 1-Antitrypsin