Both Preoperative Perinuclear Antineutrophil Cytoplasmic Antibody and Anti-CBir1 Expression in Ulcerative Colitis Patients Influence Pouchitis Development After Ileal Pouch–Anal Anastomosis

Fleshner, Phillip; Ippoliti, Andrew; Dubinsky, Marla; Vasiliauskas, Eric A.; Mei, Ling; Papadakis, Konstantinos A.; Rotter, Jerome I.; Landers, Carol J.; Targan, Stephan R.

doi:10.1016/j.cgh.2008.01.002

Cited by 124 publications

(69 citation statements)

References 37 publications

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“…This may be important as the efficacy of therapies may differ between the 2 pANCA subgroups. Further research is underway to delineate further the role of these markers in predicting response to therapy and post surgical prognosis [26] .…”

Section: Diagnosismentioning

confidence: 99%

Special issues in pediatric inflammatory bowel disease

Dubinsky¹

2007

WJG

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The incidence of pediatric inflammatory bowel disease (IBD) is rising and recent advances in diagnostics and therapeutics have improved the care provided to these children. There are distinguishing features worth noting between early onset and adult onset IBD. Physical and psychosocial development remains a critical target for the comprehensive management of pediatric IBD. Children are not just little adults and consideration must be given to the stages of development and how these stages impact disease presentation and management. The final stage will be the transition from pediatric care to that of adult oriented care and special consideration must be given to make this a successful process. This review highlights special considerations in the management of the child with IBD.

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Section: Diagnosismentioning

confidence: 99%

Special issues in pediatric inflammatory bowel disease

Dubinsky¹

2007

WJG

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“…In the literature, patients with chronic pouchitis include patients on maintenance antibiotic therapy because they developed early relapse after the withdrawal of antibiotics. In addition to Suzuki's report, other previous reports [10,18,22] have also categorized antibiotic-dependent and antibiotic-refractory pouchitis as chronic pouchitis.…”

Section: Discussionmentioning

confidence: 97%

Predictive Factors for Development of Chronic Pouchitis after Ileal Pouch-Anal Anastomosis in Ulcerative Colitis

Okita

Araki²,

Hashimoto³

et al. 2013

Digestion

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Background: No previous studies have examined predictive factors for chronic pouchitis after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) with consideration of changes in pouchitis subtypes during follow-up. This study evaluated the independent predictive factors for chronic pouchitis. Methods: A total of 244 consecutive patients who underwent IPAA were enrolled. We assessed the possible associations between pouchitis and clinical factors using Cox proportional hazard regression. Results: 231 patients met the inclusion criteria. 66 (28.5%) patients developed pouchitis. In 9 of 44 (20.4%) patients, antibiotic-responsive pouchitis at the first episode changed into chronic pouchitis after the occurrence of a subsequent episode. The median duration from occurrence of antibiotic-responsive pouchitis to alteration into chronic pouchitis was 502 (range 147-1,697) days. Overall pouchitis was finally classified into 35 acute pouchitis and 31 chronic pouchitis cases. Multivariate analysis revealed that a ≥7.5-g cumulative steroid dose before colectomy and a ≥500-mg monthly steroid dose just before colectomy were significant predictive factors for chronic pouchitis (p = 0.0001 and 0.0095, respectively). Conclusion: Patients with UC and a higher cumulative steroid dose before colectomy or higher monthly steroid dose just before colectomy may have a predictive factor for developing chronic pouchitis.

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“…In UC patients undergoing ileo-anal pouch surgery, high preoperative levels of pANCA have been prospectively associated with the development of pouchitis in some studies [65.] This risk may be increased by the simultaneous presence of anti-CBir1 [66]. In the same setting, patients positive for ASCA, particularly if they have relatives with CD, are at higher risk of developing CD of the pouch [67].…”

Section: Prediction Of Disease Evolution In Ucmentioning

confidence: 99%

Can We Predict the High-Risk Patient?

Benitez

Louis

2014

Dig Dis

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Background: While therapeutic strategies able to change the natural history of inflammatory bowel diseases (IBD) are being developed, factors predicting aggressive disease are needed to be able to choose the appropriate therapeutic strategy for the individual patient based on the risk/benefit ratio. The aim of this review is to focus on the tools assisting the clinician in routine practice regarding the prediction of disease evolution. Methods: A literature review was performed, which was mainly based on PubMed search, using the following terms: Crohn's disease, ulcerative colitis, inflammatory bowel disease, genetics, serology, biomarkers, endoscopy, C-reactive protein, faecal calprotectin, disease evolution and complications. Results: For the prediction of disease evolution, clinical characteristics, particularly disease location and behaviour, are probably currently the most useful. In addition, a series of biomarkers, including genetic, serological and inflammatory markers, as well as characteristics of endoscopic lesions may have an added value. Conclusions: Simple clinical, biological and endoscopic tools may help the clinician in predicting disease evolution in IBD. However, these tools are still insufficient, and prospective evaluation of new genetic and biological markers are needed.

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Both Preoperative Perinuclear Antineutrophil Cytoplasmic Antibody and Anti-CBir1 Expression in Ulcerative Colitis Patients Influence Pouchitis Development After Ileal Pouch–Anal Anastomosis

Cited by 124 publications

References 37 publications

Special issues in pediatric inflammatory bowel disease

Special issues in pediatric inflammatory bowel disease

Predictive Factors for Development of Chronic Pouchitis after Ileal Pouch-Anal Anastomosis in Ulcerative Colitis

Can We Predict the High-Risk Patient?

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