C-ANCA/proteinase 3-positive colitis in children: a distinctive form of inflammatory bowel disease or vasculitis with colitis as initial presentation?

J Pediatr Gastroenterol Nutr. 2013 Oct;57(4):489-92. doi: 10.1097/MPG.0b013e31829d4e9e.

Abstract

Aim: Anti-neutrophil cytoplasmic antibodies (ANCAs) detected by indirect immunofluorescence have been found in patients with inflammatory bowel disease (IBD). Nevertheless, specific antibodies against proteinase-3 (PR3) are rare in this context.

Methods: Sera from 30 consecutive pediatric patients with IBD were evaluated for ANCA-indirect immunofluorescence and its specific antibodies to investigate whether PR3-ANCA positivity (PR3-ANCA+) identifies a distinct IBD subtype.

Results: The 5 PR3-ANCA+ patients (17%) showed significantly more concomitant biliary disease and severe anal blood loss (P < 0.05). None had vasculitis features at diagnosis nor during follow-up.

Conclusions: This pilot study demonstrates significant clinical differences between the PR3-ANCA-positive and -negative IBD subset.

MeSH terms

  • Adolescent
  • Antibodies, Antineutrophil Cytoplasmic / blood*
  • Biliary Tract Diseases / etiology
  • Child
  • Child, Preschool
  • Colitis / blood
  • Colitis / complications
  • Colitis / diagnosis*
  • Colitis / immunology
  • Diagnosis, Differential
  • Female
  • Gastrointestinal Hemorrhage / etiology
  • Humans
  • Inflammatory Bowel Diseases / blood
  • Inflammatory Bowel Diseases / complications
  • Inflammatory Bowel Diseases / diagnosis*
  • Inflammatory Bowel Diseases / immunology
  • Male
  • Myeloblastin / immunology*
  • Vasculitis, Central Nervous System / blood
  • Vasculitis, Central Nervous System / diagnosis*
  • Vasculitis, Central Nervous System / immunology

Substances

  • Antibodies, Antineutrophil Cytoplasmic
  • Myeloblastin