Diagnostic role of anti-Saccharomyces cerevisiae mannan antibodies combined with antineutrophil cytoplasmic antibodies in patients with inflammatory bowel disease.
OBJECTIVE
Perinuclear antineutrophil cytoplasmic autoantibody is known to be a marker for ulcerative colitis, and anti-Saccharomyces cerevisiae Mannan antibody is a serologic marker associated with Crohn's disease. The aim of this study was to assess the value of detecting perinuclear antineutrophil cytoplasmic autoantibody and/or anti-Saccharomyces cerevisiae Mannan antibody for the diagnosis of ulcerative colitis, Crohn's disease, Behçet's colitis, and tuberculous colitis.


METHODS
Serum samples were obtained from 85 patients with Crohn's disease, 77 with ulcerative colitis, 36 with Behçet's colitis, 14 with tuberculous colitis, 20 healthy controls, and 21 first-degree relatives of patients with Crohn's disease. Determination of perinuclear antineutrophil cytoplasmic autoantibody and anti-Saccharomyces cerevisiae Mannan antibody was performed with the standardized indirect immunofluorescence technique and an enzyme-linked immunosorbent assay, respectively.


RESULTS
A relatively high percentage of patients with Crohn's disease (49.4 percent), relatives of Crohn's disease patients (61.9 percent), and patients with Behçet's disease (41.7 percent) tested seropositive for anti-Saccharomyces cerevisiae Mannan antibody compared with normal controls (10 percent). In cases of ulcerative colitis, 44.2 percent tested seropositive for perinuclear antineutrophil cytoplasmic autoantibody, whereas the controls showed 0 percent positivity. The combination of a positive anti-Saccharomyces cerevisiae Mannan antibody test and a negative perinuclear antineutrophil cytoplasmic autoantibody yielded a sensitivity and specificity of 48.2 and 87 percent, respectively, for Crohn's disease. The combination of a positive perinuclear antineutrophil cytoplasmic autoantibody test and a negative anti-Saccharomyces cerevisiae Mannan antibody test yielded a sensitivity and specificity of 36.4 and 97.6 percent, respectively, for ulcerative colitis.


CONCLUSIONS
Anti-Saccharomyces cerevisiae Mannan antibody may be associated with Crohn's disease and Behçet's disease and perinuclear antineutrophil cytoplasmic autoantibody with ulcerative colitis. A combination of both tests may aid the differential diagnosis of inflammatory bowel disease.
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Chongno-gu, Seoul, Korea.
Byeong Gwan
BG
Kim
You Sun
YS
Kim
Joo Sung
JS
Kim
Hyun Chae
HC
Jung
In Sung
IS
Song
D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood / Q000276:immunology*; D000908:Antibodies, Fungal / Q000097:blood / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000097:blood / Q000175:diagnosis* / Q000276:immunology*; D008297:Male; D011446:Prospective Studies; D012441:Saccharomyces cerevisiae / Q000276:immunology*; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
D019268:Antibodies, Antineutrophil Cytoplasmic; D000908:Antibodies, Fungal; D015415:Biomarkers