Chronic inflammatory bowel diseases: Which choice for the autoantibodies?

The diagnosis of inflammatory bowel disease (IBD) based on a cluster of clinical and biological arguments includes two steps. First, IBD have to be distinguished from other digestive diseases, and then, it is important to separate among the major forms of IBD: Crohn's disease (CD) from ulcerative colitis (UC). The aim of this study was to compare different autoantibodies (Ab) in an unselected population of 38 undeterminated colitis diagnosis including CD patients (N=10) and UC patients (N=13) for whom the diagnosis was established a posteriori. According to our results, antilactoferrin (LF) Abs exist in 56.5% of the maladie inflammatoire chronique de l'intestin (MICI) but the specificity of such a test is moderate (66.7%). When IBD is established, anti-Saccharomyce cerevisiae Abs, on one hand, and anti-perinuclear neutrophil cytoplasmic Abs (p-ANCA), on the other hand, allowed to discriminate between CD and UC, respectively, but sensibility for both tests are moderate (<= 30%). On the whole, anti-LF, ASCA and p-ANCA may help to make earlier diagnosis of CD or UC. (C) 2008 Elsevier Masson SAS. All rights reserved.