Serological Markers

Identification of perinuclear antineutrophil cytoplasmic antibodies (pANCA) and anti-Saccharomyces cerevisiae antibodies (ASCA) antibodies, which present quite good specificity for UC and CD, initially suggested how their combined screening could better characterise patients with IC [19, 20]. However, their sensitivity is limited to 40-60% so that their value in the clinical practice is still controversial. Peeters et al. [21] found in 28 patients with IC an intermediate frequency of pANCA and ASCA. In these patients with high prevalence of both antibodies, combination of results showed and high predictive value, and the authors concluded that ASCA+/pANCA- predicts CD in 80% of patients with IC and that ASCA-/pANCA+ predicts UC in 63.6%. Interestingly, 48.5% of patients do not show antibodies against ASCA or pANCA. Most of these patients remain diagnosed with IC during their further clinical course, "perhaps reflecting a distinct clinicoserological entity". Similar results have been reported by a large prospective study [7]. Recently, Hui et al. [22] showed a significant relation between high expression of antibodies [defined as positive antibody reactivity profile (ARP)] before ileal pouch-anal anastomosis and chronic pouchitis after surgery. The authors suggest that in patients with positive ARP, aggressive traditional or experimental medication should be considered to avoid surgery due to the higher risk of chronic pouchitis or CD postsurgical development

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