Do I Have Crohn’s Disease or Ulcerative Colitis? Identifying Factors That Distinguish CD from UC and Indeterminate Colitis

Objective. The aim of this study was to evaluate the incidence of inflammatory bowel disease in Kaunas and its region during a 3-year period. Material and Methods. The study was conducted during the 3-year period (2007–2009) and enrolled the patients from Kaunas with its region, which has a population of 381 300 inhabitants. The data were collected from all practices in the area where the diagnosis of inflammatory bowel disease was made by practicing gastroenterologists and consulting pediatricians along with endoscopists. Only new cases of inflammatory bowel disease were included into analysis. The diagnosis of ulcerative colitis and Crohn’s disease was strictly made according to the Copenhagen criteria. Age- and sex-standardized incidence was calculated for each year of the study period. Results. A total of 108 new inflammatory bowel disease cases were diagnosed during the study period: 87 had ulcerative colitis, 16 Crohn’s disease, and 5 indeterminate colitis. The incidence of ulcerative colitis, Crohn’s disease, and indeterminate colitis for each study year was 6.85, 5.33, and 7.38 per 100 000; 0.95, 1.11, and 1.57 per 100 000; and 0.47, 0.21, and 0.42 per 100 000, respectively. The average 3-year standardized incidence of ulcerative colitis, Crohn’s disease, and indeterminate colitis was 6.52, 1.21, and 0.37 per 100 000, respectively. The mean patients’ age at onset of ulcerative colitis, indeterminate colitis, and Crohn’s disease was 49.95 (SD, 17.03), 49.80 (SD, 17.71), and 34.94 years (SD, 0.37), respectively. Conclusions. The average 3-year incidence of ulcerative colitis in Kaunas region was found to be lower as compared with that in many parts of Central and Western Europe. The incidence of Crohn’s disease was low and very similar to other countries of Eastern Europe. Age at onset of the diseases appeared to be older than that reported in the Western industrialized countries.

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Atypical pANCA as a marker of indeterminate colitis for the prediction of ulcerative colitis and crohn’s disease

Wiener klinische Wochenschrift ◽

10.1007/s00508-013-0363-x ◽

2013 ◽

Vol 125 (9-10) ◽

pp. 279-282 ◽

Cited By ~ 2

Author(s):

Murat Kekilli ◽

Yavuz Beyazit ◽

Adnan Tas ◽

Bilge Tunc ◽

Abdurrahim Sayilir ◽

...

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Indeterminate Colitis

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Development of an Assay for Antibodies toSaccharomyces cerevisiae: Easy, Cheap and Specific for Crohn's Disease

Canadian Journal of Gastroenterology ◽

10.1155/2001/605470 ◽

2001 ◽

Vol 15 (8) ◽

pp. 499-504 ◽

Cited By ~ 14

Author(s):

Charles N Bernstein ◽

Ken Orr ◽

James F Blanchard ◽

Michael Sargent ◽

Donna Workman

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Disease ◽

Gastrointestinal Disease ◽

Research Centre ◽

Total Charge ◽

Indeterminate Colitis ◽

Inflammatory Bowel

OBJECTIVE: To develop a serological test to measure antibodies toSaccharomyces cerevisiaein patients with inflammatory bowel disease.METHODS: An ELISA to the mannan ofS cerevisiaethat is commercially available was developed. Sera were tested from randomly chosen sera specimens kept frozen at the University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba. Clinical diagnoses were kept blinded until the assay results were finalized. One hundred thirty-six sera were tested, including 51 with Crohn's disease, 32 with ulcerative colitis, one with indeterminate colitis and 16 other control subjects. Thirty-six samples were duplicates from patients already studied but were either run on separate days or drawn on different days.RESULTS: Using a cutoff of 15 binding units as a positive result, Crohn's disease was found to have a sensitivity of 53% but a specificity of 100% compared with ulcerative colitis. Compared with all other diagnoses (including ulcerative colitis), Crohn's disease had a sensitivity of 53% and a specificity of 96%. For patients with Crohn's disease only, those who were anti-S cerevisiaeantibody (ASCA) positive (n=27) were significantly more likely to have proximal gastrointestinal disease and significantly less likely to have colonic or inflammatory type disease than those who were ASCA negative (n=24). The direct cost of this assay was $6.00 per positive test, and the total charge was set at $38.15.CONCLUSIONS: A reasonably inexpensive, easy and reproducible assay to assess for antibodies toS cerevisiaehas been developed. Using a cutoff for positivity of 15 binding units, this test had a specificity of 100% for ruling out Crohn's disease and a lower (60%) sensitivity compared with ulcerative colitis. This test could identify a specific phenotype of patients with Crohn's disease as being more likely to have small bowel Crohn's disease and less likely to have colonic (isolated) or inflammatory disease, as opposed to fibrostenotic disease or penetrating disease. The test proved reliable when assaying samples drawn or assayed on different days.

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The Anti-Saccharomyces Cerevisiae Antibody Assay in a Province-Wide Practice: Accurate in Identifying Cases of Crohn’s Disease and Predicting Inflammatory Disease

Canadian Journal of Gastroenterology ◽

10.1155/2005/147681 ◽

2005 ◽

Vol 19 (12) ◽

pp. 717-721 ◽

Cited By ~ 13

Author(s):

Brinderjit Kaila ◽

Kenneth Orr ◽

Charles N Bernstein

Keyword(s):

Saccharomyces Cerevisiae ◽

Ulcerative Colitis ◽

Crohn’S Disease ◽

Celiac Disease ◽

Crohn's Disease ◽

Inflammatory Disease ◽

Gastrointestinal Symptoms ◽

Final Diagnosis ◽

Elisa Test ◽

Indeterminate Colitis

OBJECTIVE: To determine the utility of the anti-Saccharomyces cerevisiae antibody (ASCA) ELISA test developed in Manitoba in 2001 in a population-wide sample referred from physicians across Manitoba in their investigation of patients with gastrointestinal symptoms.METHODS: Patients whose serum was referred for ASCA testing in 2001 and 2002 were eligible for the present study. ELISA was performed by a technologist, blind to patient diagnoses. A single investigator contacted physicians to facilitate chart review. Data collected included demographics, final diagnoses and tests used to substantiate the final diagnosis.RESULTS: Of 482 subjects identified, 410 charts were available for review and 29 of those were unavailable for follow-up or had incomplete charts. The present study population included Crohn's disease (CD, n=114), ulcerative colitis (n=74), indeterminate colitis (n=31), celiac disease (n=9), irritable bowel syndrome (n=75), other diagnoses (n=33) and no disease (n=45). ASCA had a sensitivity of 37% (95% CI 27.8 to 46.8) and specificity of 97% (95% CI 93.8 to 98.6) for diagnosing CD and an odds ratio for a diagnosis of CD of 18.4 (95% CI 8.2 to 41.3). The 47 ASCA-positive patients included the following diagnoses: CD=39, ulcerative colitis=3, indeterminate colitis=1, celiac disease=3 and no disease=1. The likelihood of having an inflammatory disease if ASCA is positive was nearly 40-fold.CONCLUSION: A positive ASCA test using this assay nearly clinches a diagnosis of some form of inflammatory intestinal disease, which is highly likely to be CD. In symptomatic patients, a positive ASCA test should encourage the clinician to pursue further investigations

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Perinuclear Antineutrophil Cytoplasmic Autoantibodies and Anti-Saccharomyces CerevisiaeAntibodies as Serological Markers Are Not Specific in the Identification of Crohn’s Disease and Ulcerative Colitis

Canadian Journal of Gastroenterology ◽

10.1155/2008/974540 ◽

2008 ◽

Vol 22 (1) ◽

pp. 33-36 ◽

Cited By ~ 17

Author(s):

Vishal Anand ◽

Anthony S Russell ◽

Ross Tsuyuki ◽

Richard Fedorak

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Demographic Data ◽

Disease Diagnosis ◽

Indeterminate Colitis ◽

Serological Markers ◽

Negative Results ◽

Inflammatory Bowel ◽

Antineutrophil Cytoplasmic Autoantibodies

OBJECTIVE: To evaluate the diagnostic accuracy of perinuclear antineutrophil cytoplasmic autoantibodies (pANCAs) and anti-Saccharomyces cerevisiaeantibodies (ASCAs), as single agents and in combination, for the diagnosis of Crohn’s disease (CD) and ulcerative colitis (UC), including in cases of indeterminate colitis (IC).METHODS: The sera from a total of 98 patients were studied: 77 with CD, 16 with UC and five with IC. The medical records of these patients were reviewed for disease diagnosis, demographic data, and patient symptoms and medications. ELISAs were utilized to detect the presence of ASCAs and deoxyribonuclease-sensitive pANCAs, and these results were then compared with the patients’ clinical data.RESULTS: For UC, a positive pANCA test alone provided a sensitivity of 50% and a specificity of 82%. For CD, a positive ASCA test alone provided a sensitivity of 40% and a specificity of 100%. A combination of pANCA-positive and ASCA-negative results showed a sensitivity of 50% and specificity of 90% for the diagnosis of UC. Similarly, the combination of ASCA-positive and pANCA-negative results provided a sensitivity and specificity of 32% and 100% for the diagnosis of CD, respectively. Interestingly, 80% of IC patients showed serology results consistent with UC.CONCLUSIONS:Although this combination of serological markers provides a diagnostic tool with generally high specificities, the low sensitivities of these serological markers, most notably in terms of CD, preclude the possibility that they can replace the tools currently used for inflammatory bowel disease diagnosis and management. It is possible, however, that these serological markers may prove beneficial in the management of IC.

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Inflammatory bowel disease

Oxford Handbook of Gastrointestinal Nursing ◽

10.1093/med/9780198833178.003.0015 ◽

2021 ◽

pp. 367-394

Author(s):

Jennie Burch ◽

Brigitte Collins

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Disease ◽

Microscopic Colitis ◽

Indeterminate Colitis ◽

Clinical Environment ◽

Inflammatory Bowel ◽

The Uk

The inflammatory bowel disease (IBD) chapter explores the umbrella term that encompasses Crohn’s disease, ulcerative colitis, indeterminate colitis and microscopic colitis. These diseases are increasing in incidence in the UK and worldwide. Symptoms can be debilitating and may not be curable. Treatment can include medication, diet and surgery but there can be extra-intestinal of IBD. There will be an in-depth focus on Crohn’s disease and ulcerative colitis to explore the definitions, symptoms, causes and incidence of each disease. Investigations for both diseases are then explained. Concise explorations on the issues related to inflammatory bowel disease, particularly ulcerative colitis and Crohn’s disease can be used within clinical environment by the nurse.

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Λοιμώξεις στην ιδιοπαθή φλεγμονώδη πάθηση των εντέρων

10.12681/eadd/47002 ◽

2019 ◽

Author(s):

Νικολέττα Καραβασίλη

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Indeterminate Colitis

Εισαγωγή: Η Ιδιοπαθής Φλεγμονώδης Νόσος του Εντέρου (Ιδιοπαθής Φλεγμονώδης Νόσος του Εντέρου-ΙΦΝΕ) αποτελεί μια νοσογόνο κατάσταση, η οποία έχει άμεση εμπλοκή με μολυσματικούς παράγοντες και λοιμώξεις σε ότι αφορά στην αιτιοπαθογένειά της και στην εξελισσόμενη κλινική της πορεία. Σκοπός: Σκοπός της παρούσας μελέτης ήταν η διερεύνηση των λοιμώξεων σε ασθενείς με ΙΦΝΕ, οι οποίοι παρακολουθούνταν τα τελευταία 30 χρόνια. Μεθοδολογία: Πραγματοποιήθηκε αναδρομική μελέτη καταγραφής, μέσα από τα αρχεία της Γαστρεντερολογικής Κλινικής και του αντίστοιχου Εξωτερικού Ιατρείου. Στη μελέτη συμπεριλήφθησαν ασθενείς με ΙΦΝΕ, οι οποίοι παρακολουθούνταν στην Γαστρεντερολογική Κλινική και την Α΄ Παθολογική Κλινική του Πανεπιστημιακού Γενικού Νοσοκομείου Ιωαννίνων, το Γενικό Νοσοκομείο Ιωαννίνων "Γ. Χατζηκώστα", καθώς και από τους Γαστρεντερολόγους της Υγειονομικής Περιφέρειας, μεταξύ των ετών 1982-2012. Αποτελέσματα: Από το σύνολο των 527 περιστατικών με ΙΦΝΕ που ελέγχθηκαν, το 42,7%, (n=225) εμφάνισαν λοίμωξη. Επικρατέστερο αίτιο λοίμωξης ανά ασθένεια και στις δύο υποκατηγορίες ασθενών αποδείχθηκε ο βακτηριακός παράγοντας, συγκεκριμένα στους ασθενείς με νόσο Crohn (Crohn’s Disease-CD) σε ποσοστό 38,7%, ενώ στους ασθενείς με ελκώδη κολίτιδα (Ulcerative Colitis-UC) σε μεγαλύτερο ποσοστό 42%. Οι μισοί ασθενείς (51.1%) παρουσίασαν λοίμωξη 1 φορά, το 22,6% 2 φορές, το 15,6% 3 φορές και το 10,9% πάνω από 4 φορές. Οι ασθενείς με UC παρουσίασαν περισσότερες λοιμώξεις σε σχέση με τους ασθενείς με CD και αδιευκρίνιστη κολίτιδα (Indeterminate Colitis-IC) χωρίς όμως, στατιστική σημαντικότητα (57% vs 42.1% vs 33.3%, p=0.149). Η καταγραφή κατά φθίνουσα συχνότητα επί του ποσοστού λοιμώξεων κατέδειξε ότι προσβλήθηκε το γαστρεντερικό σύστημα στο 98.2% των ασθενών, στο 38.3% το δέρμα, στο 27.7% το ανώτερο αναπνευστικό σύστημα και στο 16.8% το ουροποιητικό σύστημα. Ιδιαίτερα, σε σχέση με την προσβολή του γαστρεντερικού συστήματος, το οποίο είναι κύριο όργανο έκφρασης της ΙΦΝΕ, το 45.9% των λοιμώξεων ήταν βακτηριακής αιτιολογίας. Από το σύνολο των ασθενών, το 39.6% χρειάσθηκε να εισαχθεί στο νοσοκομείο και να αντιμετωπιστεί η λοίμωξη ενδονοσοκομειακά, λόγω βαρύτητας της νόσου, με μέση διάρκεια νοσηλείας τις 11,1 (±9) ημέρες, ενώ η προσβολή του γαστρεντερικού συστήματος συνοδεύτηκε με αύξηση του μέσου όρου ημερών νοσηλείας κατά περίπου 3 ημέρες (13,6±3,4). Βρέθηκε θετική συσχέτιση μεταξύ της θεραπείας με αζαθειοπρίνη και του κινδύνου για ιογενή λοίμωξη (29.6%, p=0.031). Το 37.5% των ασθενών που ελάμβανε μεσαλαζίνη εμφάνισε 1 φορά λοίμωξη, το 29.3% των ασθενών που ελάμβανε αζαθειοπρίνη εμφάνισε 2 φορές, το 41.7% των ασθενών που ελάμβανε μεθοτρεξάτη εμφάνισε 4 φορές, όπως και το 40% των ασθενών που ελάμβανε Infliximab, ευρήματα με στατιστική σημαντικότητα (p=0,001, p=0,001, p=0,006, p=0,002, αντίστοιχα). Τέλος, το 4.9% των ασθενών εμφάνισε φυματίωση. Συμπεράσματα: Η εμφάνιση λοιμώξεων σε αυτούς τους ασθενείς είναι συχνή και για τη βέλτιστη αντιμετώπισή τους οφείλει η επιστημονική ομάδα να βρίσκεται σε εγρήγορση για την καλύτερη δυνατή αντιμετώπιση. Οι ασθενείς θα πρέπει να ενημερώνονται σχετικά με τους κινδύνους ανάπτυξης λοίμωξης και να εκπαιδεύονται στους τρόπους πρόληψης.

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