Atypical perinuclear antineutrophil cytoplasmic antibodies in patients with Crohn's disease

Can J Gastroenterol. 1997 Nov-Dec;11(8):689-93. doi: 10.1155/1997/237085.


Atypical perinuclear antineutrophil cytoplasmic antibodies (p-ANCA) occur in most patients with ulcerative colitis but only in a minority of those with Crohn's disease. In a recent study from the United States, this serological marker was reported to be present in 100% of Crohn's disease patients with a clinical phenotype of' left-sided ulcerative colitis' but was not present in patients with 'isolated' small bowel disease. In a previously reported survey from the author's hospital, the p-ANCA status of 247 consecutive patients with Crohn's disease was evaluated, and, of these, 33 Crohn's disease patients were seropositive, including 18 (13.0%) with combined small and large bowel disease, 11 (19.6%) with 'isolated' colorecral disease, and four (4.6%) with 'isolated' small bowel but no detectable colorectal disease. To further evaluate and verify the significance of atypical p-ANCA in these 33 patients, clinical, radiological, endoscopic and histological features were examined. This study confirms that an 'ulcerative colitis-like' clinical phenotype may be seen in most, but not all, serologically positive Crohn's disease patients. Moreover, 'isolated' small bowel disease in the absence of colorectal disease occurs. Detection of atypical p-ANCA in Crohn's disease with different clinical and pathological features provides serological evidence that Crohn's disease is a very heterogeneous disorder.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Antineutrophil Cytoplasmic / analysis*
  • Anus Diseases / pathology
  • Biomarkers / analysis
  • Child
  • Colitis, Ulcerative / immunology
  • Colitis, Ulcerative / pathology
  • Colonic Diseases / pathology
  • Crohn Disease / diagnostic imaging
  • Crohn Disease / drug therapy
  • Crohn Disease / immunology
  • Crohn Disease / pathology*
  • Crohn Disease / surgery
  • Cutaneous Fistula / pathology
  • Endoscopy, Gastrointestinal
  • Evaluation Studies as Topic
  • Female
  • Fluorescent Antibody Technique, Indirect
  • Follow-Up Studies
  • Granuloma / pathology
  • Humans
  • Intestinal Fistula / pathology
  • Intestine, Large / pathology
  • Intestine, Small / pathology
  • Male
  • Middle Aged
  • Phenotype
  • Radiography
  • Rectal Diseases / pathology
  • Vaginal Fistula / pathology


  • Antibodies, Antineutrophil Cytoplasmic
  • Biomarkers