Possible Relation of Crohn's Disease and Hereditary Thrombophilia: Detection of ASCA Seropositivity. (Preliminary Results).

Abstract

Introduction: Hereditary thrombophilia (Factor V Leiden mutation -FV G1691A, FVL, FII G20210A -prothrombin mutation), has been reported to be correlated to Crohn's disease (CD) by some studies. The determination of anti- Saccharomyces Cerevisiae IgA and IgG Antibodies (ASCA) have been described as important serological marker for the differential diagnosis of CD. The aim of the study was to evaluate ASCA seropositivity in a high-risk population (i.e. thrombophilic patients, pts) for CD.Material-Methods: From April to July 2004, 37 patients (16 men, 21 women, mean age 52,5± 9.6 years old) with hereditary thrombophilia and 28 healthy control subjects (16 men, 12 women, mean age 51,3 ± 8.5 years) were included in the study. Fasting blood samples were drawn from patients and control subjects were examined for serum p-ANCA, ASCA IgA and IgG titers. Pts and control subjects were matched for age, sex and smoking and had to fill a questionnaire concerning history of rectal bleeding, diarrhea lasting longer than 4 weeks, inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS).Colonoscopy or flexible sigmoidoscopy was proposed to all patients and controls when reported an alarm symptom. ASCA IgA and IgG titers were measured with quantitative enzyme immunoassay method (Medizym ASCA IgG, Medizym ASCA IgA, and MEDIPAN, GERMANY).Results: In the patient group 8 pts reported IBS symptoms, 2 had history of rectal bleeding while none IBD or chronic diarrhea. In the control group 6 patients reported IBS symptoms while none IBD, rectal bleeding or chronic diarrhea (p>0,05). Ten and 15 pts were found to be positive for ASCA IgG and IgA respectively. In the control group, 6 and 10 subjects were found to be positive for ASCA IgG and IgA respectively (p<0,05 and p<0,1 respectively).Conclusions: Thrombophilic pts, a high-risk population for CD, present an important rate of ASCA IgG and IgA seropositivity. Although these are preliminary results, thrombophilic pts should be screened for ASCA and some of them with colonoscopy. ASCA seropositivity in the control group was found to be greater than in the literature but this may be explained by the small sample.