PR3-ANCA and panel diagnostics in pediatric inflammatory bowel disease to distinguish ulcerative colitis from Crohn's disease

Horn, Michael; Peter, Anna Maria; Righini Grunder, Franziska; Leichtle, Alexander Benedikt; Spalinger, Johannes; Schibli, Susanne; Sokollik, Christiane (2018). PR3-ANCA and panel diagnostics in pediatric inflammatory bowel disease to distinguish ulcerative colitis from Crohn's disease. PLoS ONE, 13(12), e0208974. Public Library of Science 10.1371/journal.pone.0208974

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Background Accurate classification of patients with inflammatory bowel disease into the subtypes ulcerative colitis (UC) and Crohn’s disease (CD) is still a challenge, but important for therapy and prognosis. Objectives To evaluate the diagnostic utility of anti-neutrophil cytoplasmic antibodies specific for proteinase- 3 (PR3-ANCA) for ulcerative colitis (UC) and the value of an antibody panel incorporating PR3-ANCA to differentiate between Crohn’s disease (CD) and UC. Study design In this cohort study, 122 pediatric and adolescent individuals were retrospectively included (61 IBD patients of two clinical centers, 61 non-IBD controls). All subjects had a comprehensive antibody profile done from stored sera taken close to time of diagnosis. By employing quasi-exhaustive logistic regression the best discriminative model for UC and CD,subjects was determined in a training cohort and confirmed in a validation cohort. Results PR3-ANCA was specifically associated with UC (odds ratio (OR), 17.6; 95% confidence interval (CI); 3.6, 87); P < .001). A four antibody-panel including PR3-ANCA had an AUC of 90.81% (95%CI; 81.93, 99.69) to distinguish between UC and CD in the training cohort. In a smaller external validation cohort, the AUC was 84.13% (95%CI; 64.21, 100) for accurate diagnosis of CD and UC. Conclusion PR3-ANCA is highly specific for UC. The differentiating capability of a panel, which contains PR3-ANCA and weighs broadly available antibodies, is superior and utilization of the panel can support accurate classification in the work-up of pediatric and adolescent patients with IBD patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute of Clinical Chemistry
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine

UniBE Contributor:

Horn, Michael; Peter, Anna Maria; Leichtle, Alexander Benedikt; Schibli, Susanne and Sokollik, Christiane

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1932-6203

Publisher:

Public Library of Science

Language:

English

Submitter:

Christiane Sokollik

Date Deposited:

05 Feb 2019 14:02

Last Modified:

10 Feb 2019 02:38

Publisher DOI:

10.1371/journal.pone.0208974

PubMed ID:

30557305

BORIS DOI:

10.7892/boris.123520

URI:

https://boris.unibe.ch/id/eprint/123520

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