Antineutrophil cytoplasmic antibodies in sera from colectomised ulcerative colitis patients and its relation to the presence of pouchitis.
BACKGROUND
Few studies have evaluated the influence of colectomy on antineutrophil cytoplasmic antibody (ANCA) positivity in ulcerative colitis (UC). In small series of patients it has been suggested that ANCA positivity in UC might be predictive for development of pouchitis after colectomy.


OBJECTIVE
To assess the prevalence of ANCA in UC patients treated by colectomy and a Brooke's ileostomy (UC-BI) or ileal pouch anal anastomosis (UC-IPAA), and the relation between the presence of ANCA, the type of surgery, and the presence of pouchitis.


METHODS
63 UC patients treated by colectomy (32 with UC-BI and 31 with UC-IPAA), 54 UC, and 24 controls.


METHODS
Samples were obtained at least two years after colectomy. ANCA were detected by indirect immunofluorescent assay.


RESULTS
There were no differences between patients with (36.3%) or without pouchitis (35.0%) and between patients with UC (55%), UC-BI (40.6%), and UC-IPAA (35.4%). However, ANCA prevalence significantly decreases in the whole group of operated patients (38.0%) compared with non-operated UC (p = 0.044).


CONCLUSIONS
The prevalence of ANCA in operated patients was significantly lower than in non-operated UC, suggesting that it might be related either to the presence of inflamed or diseased tissue. ANCA persistence is not related to the surgical procedure and it should not be used as a marker for predicting the development of pouchitis.
Esteve
M
M
Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.
Mallolas
J
J
Klaassen
J
J
Abad-Lacruz
A
A
González-Huix
F
F
Cabré
E
E
Fernández-Bañares
F
F
Bertrán
X
X
Condom
E
E
Martí-Ragué
J
J
Gassull
M A
MA
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies / Q000097:blood*; D016022:Case-Control Studies; D003082:Colectomy / Q000009:adverse effects*; D003093:Colitis, Ulcerative / Q000601:surgery*; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007079:Ileitis / Q000175:diagnosis* / Q000209:etiology; D007081:Ileostomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D016737:Proctocolectomy, Restorative / Q000009:adverse effects
D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies