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Clustering of (auto)immune diseases with early-onset and complicated inflammatory bowel disease

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Abstract

Studies in adult inflammatory bowel disease (IBD) patients have highlighted associations with genetic and serologic markers and suggest an association with disease location, behaviour and natural history. Data on patients with Crohn’s disease (CD, n = 80), ulcerative colitis (UC, n = 15) and indeterminate colitis (n = 4) were collected. All individuals were analysed for CARD15 R702W, G908R and L1007fs for toll-like receptor 4 (TLR4) Asp299Gly and for anti-Saccharomyces cerevisiae antibodies (ASCA) and atypical perinuclear antineutrophil cytoplasmatic antibodies (pANCA). After a mean of 10.7 years of follow up, the disease behaviour changed in 45% of CD patients, in contrast to disease location, where only 12.5% had a change (p < 0.001). The younger the age at diagnosis, the more patients presented with colonic disease (p = 0.021). Also, more TLR4 Asp299 Gly variants were found when the age at onset was younger (p = 0.018). A large number of concomitant diseases were observed. There was no difference in the prevalence of TLR4 variants nor ASCA or pANCA between the patients with or without concomitant diseases. Patients who progressed more often needed surgery as compared to patients who remained free of stenosing or fistulising disease (27/32 or 84% versus 3/35 or 8.6%, respectively, p < 0.0001) and more often had concomitant immune-mediated diseases and a trend for more seroreactivity towards ASCA.

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Abbreviations

IBD:

Inflammatory bowel disease

CD:

Crohn’s disease

UC:

Ulcerative colitis

TLR4:

Toll-like receptor 4

CARD:

Caspase recruitment and oligomerisation domain

ASCA:

Anti-Saccharomyces cerevisiae antibodies

pANCA:

Atypical perinuclear antineutrophil cytoplasmatic antibodies

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Acknowledgement and grant support

This work was supported by grants from the Funds for Scientific Research Flandres (FWO), Belgium. LH is a doctoral fellow of the FWO, and SV and GVA are clinician scientists appointed by the FWO.

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Authors and Affiliations

  1. Department of Paediatric Gastroenterology, University Hospital Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium

    Mirjam Bueno de Mesquita, Virginie Janssens & Ilse Hoffman

  2. Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium

    Marc Ferrante, Liesbet Henckaerts, Marie Joossens, Tibor Hlavaty, Marie Pierik, Sofie Joossens, Nele Van Schuerbeek, Gert Van Assche, Paul Rutgeerts & Severine Vermeire

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  1. Mirjam Bueno de Mesquita
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Correspondence to Ilse Hoffman.

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Bueno de Mesquita, M., Ferrante, M., Henckaerts, L. et al. Clustering of (auto)immune diseases with early-onset and complicated inflammatory bowel disease. Eur J Pediatr 168, 575–583 (2009). https://doi.org/10.1007/s00431-008-0798-7

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  • DOI: https://doi.org/10.1007/s00431-008-0798-7

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