Presence and diagnosis of amebic infestation in Turkish patients with active ulcerative colitis.
BACKGROUND
It is difficult to definitively diagnose acute amebiasis, particularly when this condition is superimposed on inflammatory bowel disease. Our goals in this study were to determine the prevalence of amebiasis in individuals with active ulcerative colitis, and to identify clinical and laboratory parameters that are of value for diagnosing amebiasis in this patient group.


METHODS
The subjects were 111 patients (76 women, 35 men) with confirmed active ulcerative colitis who attended our hospital's Inflammatory Bowel Disease Outpatient Clinic between May 2002 and March 2006. In each case, a detailed medical history was collected, blood samples were tested for inflammatory markers, and stool samples were evaluated for presence of amebae using an Enzyme-Linked Immunosorbent Assay (ELISA) for detection of Entamoeba histolytica antigen. The clinical and laboratory variables for the ELISA-positive and ELISA-negative groups were compared.


RESULTS
Amebiasis was detected in 35 (31.5%) of the subjects. Patient age, disease duration, endoscopic activity index, serum C-reactive protein level, and white blood cell count were not useful for diagnosing amebiasis in this patient group.


CONCLUSIONS
Given the high rate of amebiasis observed in our patients with active ulcerative colitis, we recommend that, in Turkey any individual with ulcerative colitis who presents with symptoms of disease activation should be tested for ameba using antigen detection kits. A high index of suspicion is especially important in any region where E. histolytica is endemic.
Ozin
Yasemin
Y
Turkey Yuksek Ihtisas Training and Research Hospital, Gastroenterology Department, Turkey. yoozderin@gmail.com
Kilic
Mesut Zeki Yalin
MZ
Nadir
Isilay
I
Tayfur
Oyku
O
Ertas
Arzu
A
Ulker
Aysel
A
Sahin
Burhan
B
D000328:Adult; D000953:Antigens, Protozoan / Q000302:isolation & purification; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000382:microbiology*; D004404:Dysentery, Amebic / Q000175:diagnosis* / Q000453:epidemiology*; D004748:Entamoeba histolytica / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D014421:Turkey
D000953:Antigens, Protozoan