Association of antibodies to exocrine pancreas with subtypes of Crohn's disease

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Abstract
The Vienna classification of Crohn’s disease (CD) subdivides patients according to their age at diagnosis, disease location, and disease behaviour. This study tested whether antibodies against exocrine pancreatic tissue (PAbs) are associated with Vienna classification subtypes of CD. PAbs were examined by indirect immunofluorescence in sera of patients with CD (n = 208), or ulcerative colitis (n = 47), and in normal controls (n = 50). Presence of PAbs was compared to the Vienna classification, disease activity, and drug therapy. PAbs were present in 60 CD patients (28.8%), but in no patient with ulcerative colitis or in controls (P< 0.001). There was no significant association between PAbs and disease activity, or drug therapy. Complete classification into Vienna subtypes was possible in 168 patients. There was significant heterogeneity in PAb prevalence in these CD subtypes (P< 0.01). Variation was found in the behaviour category (B1, non-stricturing, non-penetrating CD: 14.0% PAb-positive; B2, stricturing CD: 41.7%; B3, penetrating CD: 31.5%; P = 0.02), but not age or location categories. PAbs were associated with long disease duration (P = 0.04). This study confirms that PAbs are highly specific for CD. The small differences in their prevalence in CD subtypes do not suggest that PAb detection is useful in discrimination of CD phenotypes.