Differential diagnosis of Crohn’s disease using antibodies to glycoprotein 2 and Saccharomyces cerevisia

Özet

Background/Aims: Glycoprotein 2 (GP2), the major autoantigen of Crohn’s disease (CD)-specific pancreatic autoantibodies, is reportedly correlated with several characteristics of CD. We investigated this serological marker in Turkish patients with CD and assessed itsutility in combination with anti-Saccharomyces cerevisiae antibodies (ASCAs) for differential diagnosis of CD.Materials and Methods: A total of 60 patients with CD, 62 patients with ulcerative colitis (UC), and 46 healthy controls with a definitediagnosis who were similar in age and sex were enrolled in the study conducted from November 2011 to October 2012. ASCA and anti-GP2 levels were measured using commercially available kits.Results: Anti-GP2 IgA and IgG levels were higher in patients with CD (25%) than in those with UC (5%) and controls (2%). The seroprevalence of anti-GP2 IgA was markedly higher than that of IgG in patients with CD in contrast to previous studies. The specificity andpositive predictive value of seropositivity for both ASCA and anti-GP2 were 100%. ASCA IgA seropositivity was correlated with a complicated disease course and a history of surgery. There was no correlation between anti-GP2 seropositivity and disease location, diseasebehavior, or a history of surgery.Conclusion: The combination of ASCA and anti-GP2 may enable differentiation of CD from UC. As ASCA seropositivity is associatedwith a more complicated disease course, patients seropositive for ASCA at the initial diagnosis should undergo more intense therapy