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P104. Anti-Saccharomyces cerevisiae antibodies in Crohn's disease: Role in disease stratification

P104. Anti-Saccharomyces cerevisiae antibodies in Crohn's disease: Role in disease stratification

C.G. Rodrigues, S.F. Alberto, L. Ricardo, A. Martins, J. Félix, E. Pires, M.J. Sousa, G. Sousa, J.R. Deus

Professor Doutor Fernando Fonseca's Hospital, Amadora, Portugal

Anti-Saccharomyces cerevisiae antibodies (ASCA) are relatively specific serological markers of Crohn's Disease (CD), and have been suggested as useful tools in prognostic stratification of patients.

Aim: The purpose was to determine the association of ASCA with the phenotypic characteristics and prognosis of CD.

Material and Methods: We included 206 patients with CD, 95 men and 111 women for whom we evaluated the location and behavior of the disease and the need for corticosteroid therapy, immunosuppression, biological therapy, hospitalization and surgery. ASCA serology was determined by ELISA (IBDX® ELISA kits; GlyCochip®), considering seropositivity for values >1/100. The statistical analysis was performed with SPSS 17.0 software (Chi2 test).

Results: According to the Montreal classification, we identified seven patients A1 (3.4%), 127 A2 (61.7%) and 72 A3 (35.0%); 98 patients L1 (47.6%), 31 L2 (15.0%), 75 L3 (36.4%) and 23 L4 (11.2%); and 22 patients B1 (59.2%), 43 B2 (20.9%) and 41 B3 (19.9%). Perianal disease was present in 58 patients (28.2%). One hundred and twelve patients (54.4%) required treatment with steroids, 64 (31.1%) were treated with azathioprine and 28 (13.6%) with biological therapy. Eighty-one patients (39.3%) required hospitalization and 69 (33.5%) needed surgery.

ASCA were positive in 104 patients (50.5%). The seropositivity was associated statistically significantly with ileal disease (46% vs 26%, p = 0.01), stricturing or penetrating behavior (28% vs 13%, p < 0.0001) and with the need for immunosuppressive therapy (19% vs 12%, p = 0.044), hospitalization (24% vs 16%, p = 0.021) and surgery (22% vs 11%, p = 0.001).

Conclusion: According to our series ASCA positive patients have a more frequent ileal involvement, a greater need for imunossupression and a worse course of disease. These may be considered when making therapeutical decisions.