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Serological markers and the risk of acute and chronic pouchitis

The latest issue of the Alimentary Pharmacology & Therapeutics reviews serological markers and the risk of acute and chronic pouchitis.

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Serological markers such as anti-neutrophil cytoplasmic antibody (ANCA) and anti-Saccharomyces cerevisiae antibody (ASCA) may be associated with pouchitis after ileal pouch-anal anastomosis (IPAA).

Dr Singh and colleagues performed a systematic review with meta-analysis of studies evaluating the association of anti-neutrophil cytoplasmic antibody, and anti-Saccharomyces cerevisiae antibody status with risk of acute and chronic pouchitis after ileal pouch-anal anastomosis.

The team searched multiple databases for studies reporting anti-neutrophil cytoplasmic antibody and/or anti-Saccharomyces cerevisiae antibody status along with risk of acute or chronic pouchitis after ileal pouch-anal anastomosis in adults with ulcerative colitis.

The research team abstracted odds ratio or raw data from the individual studies to calculate summary odds ratio estimates with 95% confidence intervals using random-effects model.

The team of doctors included 8 studies reporting 184 cases of acute pouchitis and 6 studies reporting 151 cases of chronic pouchitis.

The odds of chronic pouchitis were 76% higher in anti-neutrophil cytoplasmic antibody-positive patients than anti-neutrophil cytoplasmic antibody-negative.

The researchers assessed that anti-Saccharomyces cerevisiae antibody-positivity was not associated with the risk of chronic pouchitis.

The odds of chronic pouchitis were 76% higher in anti-neutrophil cytoplasmic antibody-positive patients
Alimentary Pharmacology & Therapeutics

Neither anti-neutrophil cytoplasmic antibody  nor anti-Saccharomyces cerevisiae antibody-positivity were associated with the risk of acute pouchitis.

Dr Sing's team commented that "The risk of chronic pouchitis after ileal pouch-anal anastomosis higher in anti-neutrophil cytoplasmic antibody-positive patients, but the risk of acute pouchitis is unaffected by anti-neutrophil cytoplasmic antibody status."

"Anti-Saccharomyces cerevisiae antibody status was not associated with the risk of acute or chronic pouchitis."

"This information may be used to counsel ulcerative colitis patients regarding their risk of pouchitis after ileal pouch-anal anastomosis."

Aliment Pharmacol Ther 2013: 37(9):  876-875
11 April 2013

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