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THE PREVALENCE AND CLINICAL SIGNIFICANCE OF PERINUCLEAR ANTINEUTROPHIL CYTOPLASMIC ANTIBODY IN PATIENTS WITH INDETERMINATE COLITIS

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Abstract

Background: Indeterminate colitis (IC), a term originated by pathologists to characterize confounding histopathlogic appearance of resected mucosa, has become catch phrase for cases in which diagnostic criteria at all levels elude classification as Crohn's disease (CD) or ulcerative colitis (UC).OBJECTIVES: evaluate the prevalence of pANCA expression in the sera and its isotypes. Patients and methods: PATIENTS GROUP consisted of 60 patients (40 males and 20 females) with indeterminate colitis and their age range was (19-84 years). CONTROL GROUP consisted of 30 (15 males and 15 females) healthy volunteers and their age range was (20- 66 years). Antineutrophil cytoplasmic ( pANCA and cANCA) testing was performed by an IIF technique on ethanol fixed human EOH granulocytes as substrate (EUROIMMUNE- Germany). Sigmoidoscope and colonoscope examination were done for the patients group and biopsies were taken from the patients for histopathological examination.Results:Serological results of ANCA showed a significant increased frequency of pANCA (63.3%) in indeterminate colitis patients as compared to controls (p=0.000). The highest percentage of this pANCA titer was 1:10 (p=0.000) then 1:100 (p=0.008) and most of them was IgG (53.3%) (p=0.000). Sensitivity of pANCA was 60%, specificity of pANCA was 40%, positive predictive value of pANCA was 61.1% and negative predictive value of pANCA was 66.6%. cANCA did not demonstrated in both groups. Conclusions : pANCA was more prevalent in indeterminate colitis and could be used as a predictive serological marker for the outcome of disease.


Article
Estimation of Antibodies against Saccharomyces Cerevisiae in Patients with Indeterminate Colitis

Author: Batool M. Mahdi بتول مهدي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 1 Pages: 61-65
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Indeterminate colitis (IC) originally referred to those 10–15% of cases of inflammatory bowel disease (IBD) in which there was difficulty distinguishing between ulcerative colitis (UC) and Crohn’s disease (CD) in the colectomy specimen and histopathology examination. However, IC is increasingly used when a definitive diagnosis of UC or CD cannot be made at colonoscopy examination, colonic biopsies or at colectomy. The diagnostic difficulties may explain the variably reported prevalence of IC. Clinically, most patients with IC evolve to a definite diagnosis of UC or CD on follow up.Patients and methods: PATIENTS GROUP: Consisted of 80 patients with indeterminate colitis (IC), their age ranged (16-84 years), mean age was 45.5 years, 50 (62.5%) were males and 30 (37.5%) were females. CONTROL GROUP: Consist of 40 healthy volunteers, mean age was 39.3 years, 20 of them were male and the rest were females. Anti-Saccharomyces cerevisiae antibodies (ASCA) were detected using indirect immunofluorescence test (IIF) test. Results: Results of ASCA antibodies in the serum of IC patients showed significant higher frequency (66.2%)(p>0.001) than control group(7.5%). The commonest isotype of this ASCA antibody was IgG (53.7%) that is significantly higher than control group (P>0.001). The sensitivity of ASCA was 63.1 %, specificity was 28.5% and positive predictive value of ASCA was 80% and negative predictive value was 78.5%.Conclusions: In conclusion, higher frequency of ASCA (IgG) expression in IC was useful in early estimation of IC and could be used as serological marker.Keywords: Anti Saccharomyces Cerevisiae Antibody (ASCA), indeterminate colitis, immuno fluorescence.

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