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Diagnostic Role of Anti- Saccharomyces cerevisiae Mannan Antibodies Combined With Antineutrophil Cytoplasmic Antibodies in Patients With Inflammatory Bowel Disease

2002; Lippincott Williams & Wilkins; Volume: 45; Issue: 8 Linguagem: Inglês

10.1007/s10350-004-6361-3

1530-0358

Byeong Gwan Kim, You Sun Kim, Joo Sung Kim, Hyun Chae Jung, In Sung Song,

Chronic Lymphocytic Leukemia Research

PURPOSE: Perinuclear antineutrophil cytoplasmic autoantibody is known to be a marker for ulcerative colitis, and anti-Saccharomyces cerevisiaeMannan 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 cerevisiaeMannan 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 cerevisiaeMannan 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 cerevisiaeMannan 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 cerevisiaeMannan 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 cerevisiaeMannan antibody test yielded a sensitivity and specificity of 36.4 and 97.6 percent, respectively, for ulcerative colitis. CONCLUSION: Anti-Saccharomyces cerevisiaeMannan 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.