title: Perinuclear antineutrophil cytoplasmic antibodies in patients with Crohn's disease define a clinical subgroup.
abstract: OBJECTIVE
  Antineutrophil cytoplasmic antibodies (ANCA) have been consistently detected in a subgroup of patients with Crohn's disease (CD). This study was designed to determine whether serum ANCA expression in patients with CD characterizes an identifiable clinical subgroup.
  
  
  METHODS
  The study population consisted of 69 consecutive patients with an established diagnosis of CD as determined by a combination of characteristic clinical, radiographic, endoscopic, and histopathologic criteria. Sera from the patients were analyzed for the presence of ANCAs using the fixed neutrophil enzyme-linked immunosorbent assay (ELISA) assay. Perinuclear ANCA (pANCA)-positive and cytoplasmic ANCA (cANCA)-positive results by ELISA were confirmed by indirect immunofluorescence staining. Clinical profiles of the ANCA-positive patients with CD were compared with those of patients with CD not expressing ANCA (ANCA-negative).
  
  
  RESULTS
  pANCA-positive patients with CD have endoscopically and/or histopathologically documented left-sided colitis and symptoms of left-sided colonic inflammation, clinically reflected by rectal bleeding and mucus discharge, urgency, and treatment with topical agents. One hundred percent of patients with CD expressing pANCA had "UC-like" features.
  
  
  CONCLUSIONS
  In patients with CD, serum pANCA expression characterizes a UC-like clinical phenotype. Stratification of CD by serum pANCA provides evidence of heterogeneity within CD and suggests a common intestinal mucosal inflammatory process among a definable subgroup of patients with CD and UC expressing this marker.
authors.affiliation: Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Vasiliauskas
authors.forename: S E
authors.initials: SE
authors.lastname: Plevy
authors.forename: C J
authors.initials: CJ
authors.lastname: Landers
authors.forename: S W
authors.initials: SW
authors.lastname: Binder
authors.forename: D M
authors.initials: DM
authors.lastname: Ferguson
authors.forename: H
authors.initials: H
authors.lastname: Yang
authors.forename: J I
authors.initials: JI
authors.lastname: Rotter
authors.forename: A
authors.initials: A
authors.lastname: Vidrich
authors.forename: S R
authors.initials: SR
authors.lastname: Targan
mesh_terms: D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis*; D015415:Biomarkers; D003093:Colitis, Ulcerative / Q000276:immunology / Q000473:pathology; D003424:Crohn Disease / Q000145:classification* / Q000276:immunology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D010641:Phenotype
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D015415:Biomarkers