title: Subclinical intestinal inflammation in chronic granulomatous disease patients.
abstract: Chronic granulomatous disease is a primary immunodeficiency caused by impaired neutrophil production of reactive oxygen species. Non-infectious colitis is common in chronic granulomatous disease, and high levels of antimicrobial antibodies that are associated with Crohn's disease are common even without colitis. Fecal calprotectin concentration is a marker for intestinal inflammation. We sought to determine whether subclinical intestinal inflammation occurs in asymptomatic chronic granulomatous disease patients. Asymptomatic chronic granulomatous disease patients without overt gastrointestinal symptoms suggestive of colitis at the time of enrollment were studied for fecal calprotectin concentration, antibodies associated with Crohn's disease and systemic inflammatory markers. Eight patients were included, aged 54-176 months. In 7/8 (87.5 %) fecal calprotectin concentration was normal (<50) and elevated (137 mg/kg) in only one patient. This patient later developed colitis. In 7/8 (87.5 %) anti-Saccharomyces cerevisiae antibody was positive. C-reactive protein, albumin, complete blood count and p-anti-neutrophil cytoplasmic antibody were normal in all 8 patients. Subclinical colitis is not evident in most asymptomatic chronic granulomatous disease patients; however, in some patients, fecal calprotectin concentration may be elevated, possibly indicating the presence of subclinical colitis and predicting the occurrence of clinically relevant colitis. Serum anti-Saccharomyces cerevisiae antibody concentrations do not seem to correlate with fecal calprotectin concentration in asymptomatic chronic granulomatous disease patients.
authors.affiliation: Pediatric Immunology Clinic, Soroka University Medical Center, POB151, 84101, Beer Sheva, Israel. broides@bgu.ac.il.|Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel. broides@bgu.ac.il.
authors.forename: Arnon
authors.initials: A
authors.lastname: Broides
authors.affiliation: Parasitology Laboratory, Soroka University Medical Center, 84101, Beer Sheva, Israel.|Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel.
authors.forename: Orli
authors.initials: O
authors.lastname: Sagi
authors.affiliation: Pediatric Gastroenterology Unit, Soroka University Medical Center, 84101, Beer Sheva, Israel.|Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel.
authors.forename: Vered
authors.initials: V
authors.lastname: Pinsk
authors.affiliation: Pediatric Immunology Clinic, Soroka University Medical Center, POB151, 84101, Beer Sheva, Israel.|Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel.
authors.forename: Jacov
authors.initials: J
authors.lastname: Levy
authors.affiliation: Pediatric Gastroenterology Unit, Soroka University Medical Center, 84101, Beer Sheva, Israel.|Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel.
authors.forename: Baruch
authors.initials: B
authors.lastname: Yerushalmi
mesh_terms: D000293:Adolescent; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003092:Colitis / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D005243:Feces / Q000737:chemistry; D005260:Female; D006105:Granulomatous Disease, Chronic / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D007413:Intestinal Mucosa / Q000276:immunology*; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis / Q000378:metabolism*; D008297:Male; D009504:Neutrophils / Q000276:immunology*; D011379:Prognosis
chemical_list: D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex
keywords: Calprotectin; Chronic granulomatous disease; Colitis; Inflammatory bowel disease