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THU0219 Anti-saccharomyces cerevisae antibodies (ASCA) in active behÇet’s disease: A marker of intestinal involvement?
  1. L.L. Prado,
  2. K.L. Augusto,
  3. P.F. Magalhães,
  4. V.T. Viana,
  5. C.G.S. Saad,
  6. C.R. Gonçalves
  1. Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

Abstract

Background Behçet’s disease (BD) differentiation from inflammatory bowel diseases (IBD) based on clinical features is challenging, especially concerning gastrointestinal and articular involvement, relatively common in enteroartrhitis (EA). The presence of anti-Saccharomyces cerevisae antibodies (ASCA), a valid serological marker in Crohn’s disease, has been controversially described in BD series. On the other hand, anti-neutrophilic cytoplasmatic antibodies (ANCA) are found in systemic vasculitides and ulcerative colitis, but not in BD.

Objectives To evaluate ASCA and ANCA prevalence in BD and its possible clinical associations compared to EA.

Methods One-hundred and thirty patients were studied, 87 BD and 43 EA. All patients were interviewed by a rheumatologist, according to a standard protocol,for clinical features and disease activity indexes [Brazilian BD Current Activity Form (BR-BDCAF) for BD, Simple Clinical Colitis Activity Index (SCCAI) and Harvey-Bradshaw Index (HBI) for EA]. Autoantibodies were detected by ASCA IgG and IgA ELISA tests and ANCA indirect immunofluorescence assays. Results were expressed in means and standard deviations and all variables were compared using the student’s t-test and Fisher’s exact test. Statistical significance was determined at p<0.05.

Results The mean age (44.7±10.6 vs. 46.2±12.2 years, p=0.03) and female frequency (78% vs. 79%, p=1.00) of BD and EA patients were comparable. ASCA prevalence in BD compared to EA was similar (33% vs. 30%, p=0.84), regardless of analyzed subgroups (IgG or IgA). Of note, in further analysis ASCA prevalence in active BD (BR-BDCAF>4) was increased in male patients (62% vs. 9%, p=0.03) and in those with gastrointestinal symptoms (61% vs. 27%, p=0.04), whereas no association was observed with EA disease activity indexes. Lower ANCA prevalence was found in BD compared to EA (6% vs. 32%, p<0.001).

Conclusions ASCA seems to be a valid serological marker to discriminate in active BD a subset of male patients and gastrointestinal involvement.

  1. Filik L, Biyikoglu I. Differentiation of Behcet’s disease from inflammatory bowel diseases: anti-Saccharomyces cerevisiae antibody and anti-neutrophilic cytoplasmic antibody. World J Gastroenterol. 2008; 14(47): 7271.

Disclosure of Interest None Declared

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