Antineutrophil cytoplasmic antibodies, anti-Saccharomyces cerevisiae antibodies, and specific IgE to food allergens in children with inflammatory bowel diseases
Antineutrophil cytoplasmic antibodies, anti-Saccharomyces cerevisiae antibodies, and specific IgE to food allergens in children with inflammatory bowel diseases
复制标题
DOI：
10.1006/clim.2001.5145
复制
发表时间：
2002-02-01
影响因子：
8.6
通讯作者：
Hölzelová, E
中科院分区：
文献类型：
--
作者：
Bartunková, J;Kolárová, I;Hölzelová, E
在患有炎症性肠病（IBD）的儿科患者的初始阶段，溃疡性结肠炎（UC）和克罗恩病（CD）之间的鉴别诊断是困难的。本研究旨在确定抗中性粒细胞胞浆抗体（ANCA）和抗酿酒酵母抗体（ASCA）在IBD中的意义。对ANCA的抗原特异性、诊断意义、滴度与疾病活动性的相关性进行了详细说明。食物过敏的发生也受到质疑。对44例UC（n = 23）或CD（n = 21）儿童和疾病对照儿童（乳糜泻，n = 21）的血清样本进行了IgG ANCA、ANCA靶抗原、伊加和IgG ASCA以及食物过敏原IgE分析。结果显示，ANCA在UC中的发生率高于CD和疾病对照组（分别为74%、24%和10%）。ANCA的存在并不反映疾病活动。抗原特异性在任何组中均无差异。IgA-ASCA在CD患者中更常见（76% vs UC患者17%）。ANCA和ASCA的检测能够基于高特异性（ANCA（+）ASCA（-）92.5%用于UC，ANCA（-）ASCA（+）93.2%用于CD）明确鉴别UC和CD。食物过敏原特异性IgE分别见于8.7%、14.3%和23.8%的UC、CD和乳糜泻患者。我们的结论是，ANCA和ASCA的联合检测是一个有价值的工具，在儿童患者之间的UC和CD的鉴别诊断，最大限度地减少侵入性诊断程序。ANCA的监测、其特异性和滴度测定并未带来更多信息。食物过敏原的特异性IgE测试可以考虑在个别患者。(C)2002 Elsevier Science（美国）。
Differential diagnosis between ulcerative colitis (UC) and Crohn's disease (CD) is difficult in the initial phases in pediatric patients with inflammatory bowel diseases (IBD). This study was performed to determine the significance of anti-neutrophil cytoplasmic antibodies (ANCA) and anti-Saccharomyces cerevisiae antibodies (ASCA) in IBD. ANCA were specified with regard to their antigenic specifity, significance to the diagnosis, and correlation of titer with the disease activity. The occurrence of food allergy was questioned, too. Serum samples from 44 children with UC (n = 23) or CD (n = 21) and from disease-control children (coeliac disease, n = 21) were analyzed for IgG ANCA, ANCA target antigens, IgA and IgG ASCA, and IgE to food allergens. Results show that ANCA occur more frequently in UC than in CD and disease-control (74, 24, and 10%, respectively). The presence of ANCA does not reflect disease activity. Antigenic specificity does not differ in any group. IgA-ASCA are found more often in patients with CD (76% versus 17% in UC). The testing for both ANCA and ASCA enabled clear-cut differential diagnosis between UC and CD based on the high specificity (ANCA(+) ASCA(-) 92.5% for UC, ANCA(-) ASCA(+) 93.2% for CD). Specific IgE to food allergens were found in 8.7, 14.3, and 23.8% of patients with UC, CD, and coeliac disease, respectively. We conclude that combined testing of ANCA and ASCA represents a valuable tool in the differential diagnosis between UC and CD in pediatric patients, minimizing invasive diagnostic procedures. Monitoring of ANCA, its specificity, and titer determination does not bring more information. Testing for specific IgE to food allergens may be considered in individual patients. (C) 2002 Elsevier Science (USA).