Serologic markers and defining inflammatory bowel disease categories

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We are currently evaluating the role of perinuclear anti-neutrophil cytoplasmic antibodies (PANCA) and anti-Saccharomyces cerevisiae antibodies (ASCA) in identifying patients with ulcerative colitis and Crohn's disease previously diagnosed with indeterminate colitis.4 While PANCA was positive in 68% of those favoring ulcerative colitis, and ASCA was positive in 37% of those favoring Crohn's disease, 86% of our patients with indeterminate colitis were both p-ANCA and ASCA negative.

Recently, Joossens et al correlated serological markers with prospective follow-up evaluation in 97 adult patients with indeterminate colitis.8 After a mean follow-up of 6 years, 32% of the adult patients with indeterminate colitis were reclassi-fied as having ulcerative colitis or Crohn's disease, half of whom were positive for p-ANCA or ASCA. However, almost half of the patients with indeterminate colitis (48.5%) remained p-ANCA/ASCA negative and continued to have characteristics of indeterminate colitis even 10 years after the initial diagnosis.

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