title: Prevalence and clinical implications of positive serum anti-microsomal antibodies in symptomatic patients with ileal pouches.
abstract: OBJECTIVE
  Autoimmune disorders (AID) have been shown to be associated with chronic antibiotic-refractory pouchitis (CARP). The role of anti-microsomal antibodies in ileal pouch disorders has not been investigated. The aims of the study were to investigate the prevalence of positive anti-microsomal antibody in symptomatic patients with ileal pouches and to investigate its clinical implications.
  
  
  METHODS
  A total of 118 consecutive symptomatic patients with ileal pouches were included between January and October 2010. Anti-microsomal antibodies were measured at the time of presentation. Demographic, clinical, and laboratory characteristics were compared between patients with positive and negative anti-microsomal antibody.
  
  
  RESULTS
  There were 14 patients (11.9%) with positive serum anti-microsomal antibody. The mean age of patients in the antibody positive and negative groups were 41.8 ± 14.4 and 42.0 ± 14.0 years, respectively (p = 0.189). All 14 patients in the antibody positive group (100%) had some form of AID, as compared to 20 patients (19.2%) in the antibody negative group (p < 0.001). Four (28.6%) patients in the antibody positive group had at least one AID in addition to Hashimoto's thyroiditis in contrast to four (3.8%) in the antibody negative group (p = 0.003). In addition, five (35.7%) patients had associated primary sclerosing cholangitis (PSC) in the antibody positive group compared to nine (8.7%) in the antibody negative group (p = 0.012). Eleven patients (78.6%) in the antibody positive group required steroids for treatment of pouch related symptoms in contrast to 26/104 (25%) patients in the antibody negative group (p = 0.002).
  
  
  CONCLUSIONS
  Anti-microsomal antibodies were common in pouch patients presenting with symptoms. Patients with positive anti-microsomal antibodies were much more likely to have concurrent AID and PSC. These patients were more likely to require therapy with steroids.
authors: Department of Gastroenterology, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
authors: Udayakumar
authors: U
authors: Navaneethan
authors: Preethi G K
authors: PG
authors: Venkatesh
authors: Elena
authors: E
authors: Manilich
authors: Ravi P
authors: RP
authors: Kiran
authors: Feza H
authors: FH
authors: Remzi
authors: Bo
authors: B
authors: Shen
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001323:Autoantibodies / Q000097:blood*; D001327:Autoimmune Diseases / Q000097:blood* / Q000150:complications*; D019819:Budesonide / Q000627:therapeutic use; D015209:Cholangitis, Sclerosing / Q000150:complications; D003424:Crohn Disease / Q000150:complications; D024881:Drug Resistance, Bacterial; D005260:Female; D050031:Hashimoto Disease / Q000097:blood / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D019449:Pouchitis / Q000150:complications / Q000188:drug therapy / Q000276:immunology*
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D001323:Autoantibodies; D019819:Budesonide