Clinical features of ulcerative colitis in pANCA-positive patients in Russian Federation

Аннотация

Several antibodies have been investigated in the serum of patients with ulcerative colitis (UC). The most commonly described is perinuclear antineutrophil cytoplasm antibodies (pANCA). The aim of our study was to determine whether the presence of pANCA is associated with particular clinical features of UC in Russian patients.

Patients and Methods: Forty nine well-characterized, unrelated patients with UC were prospectively recruited from Caucasian population. Diagnosis was established on clinical findings, endoscopy and histology. ANCA (IgA and IgG) were determined in all patients by means indirect immunofluorescence. Depending on pANCA titre (normal or high) patients were divided in two groups: pANCA-positive patients (APP) with diagnostic titre >1:40 and pANCA-negative patients (ANP). Clinical data, disease activity were gathered at the time of serum sampling as well as clinical course of disease and effect of treatment were investigated in both groups.

Results: Total pANCA (IgA+IgG) were detected in 33 of 49 patients (67%), where 29 were pANCA IgG-positive (59.2%) and 8 pANCA IgA-positive (16.3%). Only 4 from 49 pANCA-positive patients (8%) had both IgA and IgG pANCA. We found that APP had worse well-being (p = 0.043), higher body temperature (p = 0.003), higher platelet level (p = 0.01) in active disease compared with ANP. APP also had greater median disease duration (p = 0.01). No significant association was found between pANCA-presence and disease activity and extent.

Conclusion: Patients with diagnostic titre of pANCA had worse well-being, higher body temperature and platelet level in active UC. It is possible depend on greater expressed inflammatory activity and autoimmune process in APP.