KMID : 1188320210150050763
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Gut and Liver 2021 Volume.15 No. 5 p.763 ~ p.770
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Anti-Saccharomyces cerevisiae Antibody in Pediatric Crohn¡¯s Disease Patients without Mucosal Healing Is a Useful Marker of Mucosal Damage
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Kim Mi-Jin
Kim Eun-Sil Kang Ben Lee Yoon Kang Eun-Suk Choe Yon-Ho
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Abstract
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Background/Aims: We evaluated whether anti-Saccharomyces cerevisiae antibody (ASCA) titers are associated with diagnostic findings, disease activity, Paris classification phenotypes, and persistence after infliximab (IFX) treatment in children with Crohn¡¯s disease (CD). We also investigated the role of ASCA as a predictor of mucosal healing (MH) and clinical remission (CR).
Methods: This study included 61 CD patients aged 19 years or younger who were diagnosed and treated between September 2010 and January 2019 and followed for at least 1 year. ASCA was regularly measured at the diagnosis of CD and at least 1 year after IFX therapy.
Results: The average follow-up period was 3.8¡¾3.4 years (range, 1.0 to 7.2 years). Regression analysis showed that the ASCA titer was the only factor associated with Simple Endoscopic Score for Crohn's Disease (SES-CD) or CR among all the parameters. In patients who had achieved MH (SES-CD=0), ASCA immunoglobulin G (IgG) was not associated with MH, but in patients without MH, ASCA IgG was associated with SES-CD (p=0.005) and CR (p<0.001). The cutoff value of ASCA IgG in patients with CR was 21.8 units. However, there was no difference in the relapse rate between the ASCA IgG-positive and -negative groups during the follow-up period.
Conclusions: In patients who have not achieved MH, ASCA IgG is closely related to mucosal damage and CR. Unlike Western studies, ASCA IgG may be more helpful in predicting prognosis than immunoglobulin A in Korean patients, but it is not an appropriate indicator to predict the relapse of CD.
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KEYWORD
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Crohn disease, Anti-Saccharomyces cerevisiae, Children, Marker, Mucosal healing
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