Digestive Diseases and Sciences

, Volume 59, Issue 1, pp 135–145

Serologic Markers Associated with Development of Crohn’s Disease After Ileal Pouch Anal Anastomosis for Ulcerative Colitis

  • Brindusa Truta
  • Dan X. Li
  • Uma Mahadevan
  • Elena R. Fisher
  • Yunn-Y Chen
  • Kim Grace
  • Fernando Velayos
  • Jonathan P. Terdiman
Original Article

DOI: 10.1007/s10620-013-2866-8

Cite this article as:
Truta, B., Li, D.X., Mahadevan, U. et al. Dig Dis Sci (2014) 59: 135. doi:10.1007/s10620-013-2866-8

Abstract

Background and Aims

One of the causes of pouch failure after ileal pouch anal anastomosis (IPAA) for ulcerative colitis (UC) is the development of de novo Crohn’s disease (CD). Our aim was to clearly define factors associated with post-IPAA CD.

Methods

We conducted a cross-sectional study to compare demographic, clinical, and serological characteristics of patients with and without post-IPAA CD. All subjects underwent testing for anti-neutrophil cytoplasm antibodies, anti-Saccaromyces cerevisiae antibodies, anti-outer membrane porin C antibodies, and anti-CBir1 flagellin (anti-CBir1). A multivariable model assessed factors associated with post-IPAA CD.

Results

Thirty-nine subjects were enrolled in the study: 20 cases and 19 controls. Patients who developed post-IPAA CD were significantly younger (median 22 ± 9.9 vs. 30 ± 11.3, p = .027) at the time of UC diagnosis and exhibited more extraintestinal manifestations compared to controls (p = .023). No significant difference between the groups was found with respect to family history, smoking, duration of illness prior to colectomy, time to the onset of pouchitis, preoperative treatment, and indication for surgery. However, the post-operative serologic profile differed significantly with far more cases having elevated anti-CBir1 titers (p = .016, OR 8.81), the latter being the only independent predictor in the combined model.

Conclusions

Patients with Crohn’s disease of the pouch were more likely to have elevated CBir1 antibodies titers than those with simple pouchitis and healthy pouches. The stability of the CBir1 antibodies (pre- and post-colectomy) must be further assessed to establish its value as an independent predictor for development of post-IPAA CD.

Keywords

Crohn’s disease Ileal pouch anal anastomosis ASCA pANCA CBir1 OmpC 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Brindusa Truta
    • 1
  • Dan X. Li
    • 2
  • Uma Mahadevan
    • 3
  • Elena R. Fisher
    • 3
  • Yunn-Y Chen
    • 4
  • Kim Grace
    • 4
  • Fernando Velayos
    • 3
  • Jonathan P. Terdiman
    • 3
  1. 1.San FranciscoUSA
  2. 2.Kaiser Permanente Santa ClaraSanta ClaraUSA
  3. 3.San FranciscoUSA
  4. 4.San FranciscoUSA

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