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Prevalence and Clinical Implications of Positive Serum Anti-Microsomal Antibodies in Symptomatic Patients with Ileal Pouches

  • Original Paper
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background and aim

Autoimmune disorders (AID) have been shown to be associated with chronic antibiotic-refractory pouchitis (CARP). The role of anti-microsomal antibodies in ileal pouch disorders has not been investigated. The aims of the study were to investigate the prevalence of positive anti-microsomal antibody in symptomatic patients with ileal pouches and to investigate its clinical implications.

Methods

A total of 118 consecutive symptomatic patients with ileal pouches were included between January and October 2010. Anti-microsomal antibodies were measured at the time of presentation. Demographic, clinical, and laboratory characteristics were compared between patients with positive and negative anti-microsomal antibody.

Results

There were 14 patients (11.9%) with positive serum anti-microsomal antibody. The mean age of patients in the antibody positive and negative groups were 41.8 ± 14.4 and 42.0 ± 14.0 years, respectively (p = 0.189). All 14 patients in the antibody positive group (100%) had some form of AID, as compared to 20 patients (19.2%) in the antibody negative group (p < 0.001). Four (28.6%) patients in the antibody positive group had at least one AID in addition to Hashimoto’s thyroiditis in contrast to four (3.8%) in the antibody negative group (p = 0.003). In addition, five (35.7%) patients had associated primary sclerosing cholangitis (PSC) in the antibody positive group compared to nine (8.7%) in the antibody negative group (p = 0.012). Eleven patients (78.6%) in the antibody positive group required steroids for treatment of pouch related symptoms in contrast to 26/104 (25%) patients in the antibody negative group (p = 0.002).

Conclusions

Anti-microsomal antibodies were common in pouch patients presenting with symptoms. Patients with positive anti-microsomal antibodies were much more likely to have concurrent AID and PSC. These patients were more likely to require therapy with steroids.

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Abbreviations

AID:

Autoimmune disorders

AIP:

Autoimmune pancreatitis

CD:

Crohn’s disease

CARP:

Chronic antibiotic refractory pouchitis

IBD:

Inflammatory bowel disease

IPAA:

Ileal pouch-anal anastomosis

NSAID:

Non-steroidal anti-inflammatory drug

PSC:

Primary sclerosing cholangitis

PDAI:

Pouchitis Disease Activity Index

TSH:

Thyroid stimulating hormone

UC:

Ulcerative colitis

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Acknowledgement

This study was supported by a BMRP grant from the Eli and Edyth Broad Foundation and a grant from Crohn’s and Colitis Foundation of America (to B.S.)

Conflict of interest

The authors declare that they have no conflict of interest.

Specific author contributions

Study concept, data monitoring and paper preparation—Udayakumar Navaneethan.

Data monitoring and paper preparation—Preethi G.K. Venkatesh.

Patient enrollment and paper revisions—Feza H. Remzi.

Statistical analysis—Elena Manilich.

Patient recruitment and paper revisions—Ravi P. Kiran.

Study concept, patient recruitment, data monitoring, paper revisions and quality assurance—Bo Shen.

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Authors and Affiliations

  1. Department of Gastroenterology, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH, 44195, USA

    Udayakumar Navaneethan, Preethi G. K. Venkatesh & Bo Shen

  2. Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH, 44195, USA

    Elena Manilich, Ravi P. Kiran & Feza H. Remzi

  3. Department of Gastroenterology-A31, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Bo Shen

Authors
  1. Udayakumar Navaneethan
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  2. Preethi G. K. Venkatesh
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  3. Elena Manilich
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  4. Ravi P. Kiran
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  5. Feza H. Remzi
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  6. Bo Shen
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Correspondence to Bo Shen.

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Navaneethan, U., Venkatesh, P.G.K., Manilich, E. et al. Prevalence and Clinical Implications of Positive Serum Anti-Microsomal Antibodies in Symptomatic Patients with Ileal Pouches. J Gastrointest Surg 15, 1577–1582 (2011). https://doi.org/10.1007/s11605-011-1586-7

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  • DOI: https://doi.org/10.1007/s11605-011-1586-7

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