Advertisement

Digestive Diseases and Sciences

, Volume 57, Issue 4, pp 1020–1025 | Cite as

Serum Antibodies and Anthropometric Data at Diagnosis in Pediatric Crohn’s Disease

  • Anna K. Trauernicht
  • Steven J. Steiner
Original Article
  • 140 Downloads

Abstract

Background

Serum antibodies, including ASCA, anti-OmpC, and ANCA, correlate with disease location and predict disease phenotype in inflammatory bowel disease.

Aim

The objective of this study was to determine relationships between serum antibody status and anthropometric data for children with newly diagnosed Crohn’s disease.

Methods

A retrospective review was conducted on children diagnosed with Crohn’s disease at our institution from 2003 to 2008. Patients who had ASCA IgA, ASCA IgG, anti-OmpC, and pANCA antibodies, and anthropometric data measured before diagnosis and therapy were included. Z-scores for height and weight were compared among groups according to the presence of specific antibodies. Spearman’s rank correlation was used to assess association between antibodies and growth data.

Results

One hundred and two patients, mean age 11.9 years, met the inclusion criteria. Patients with the presence of any of the four antibodies had lower mean height and weight z-scores than patients without any antibodies present. When individual antibodies were studied, patients with positive ASCA titers had lower mean weight and height z-scores than patients without any antibodies present. Spearman’s rank correlation coefficient demonstrated a significant association between increasing ASCA titers and lower weight z-scores, but not lower height z-scores.

Conclusions

Pediatric patients with newly diagnosed Crohn’s disease and the presence of ASCA antibodies have lower mean height and weight z-scores. This study provides evidence that specific subsets of children with Crohn’s disease may be at greater risk of growth impairment.

Keywords

Crohn’s disease Anthropometry Pediatrics Growth 

Notes

Conflicts of interest

None.

References

  1. 1.
    Ballinger A. Fundamental mechanisms of growth failure in inflammatory bowel disease. Horm Res. 2002;58:7–10.PubMedCrossRefGoogle Scholar
  2. 2.
    Kanof ME, Lake AM, Bayless TM. Decreased height velocity in children and adolescents before the diagnosis of Crohn’s disease. Gastroenterology. 1988;95:1523–1527.PubMedGoogle Scholar
  3. 3.
    Sentongo TA, Semeao EJ, Piccoli DA, Stallings VA, Zemel BS. Growth, body composition, and nutritional status in children and adolescents with Crohn’s disease. J Pediatr Gastroenterol Nutr. 2000;31:33–40.PubMedCrossRefGoogle Scholar
  4. 4.
    Griffiths AM, Nguyen P, Smith C, MacMillan JH, Sherman PM. Growth and clinical course of children with Crohn’s disease. Gut. 1993;34:939–943.PubMedCrossRefGoogle Scholar
  5. 5.
    Motil KJ, Grand RJ, Davis-Kraft L, Ferlic LL, Smith EO. Growth failure in children with inflammatory bowel disease: a prospective study. Gastroenterology. 1993;105:681–691.PubMedGoogle Scholar
  6. 6.
    Sawczenko A, Sandhu BK. Presenting features of inflammatory bowel disease in Great Britain and Ireland. Arch Dis Child. 2003;88:995–1000.PubMedCrossRefGoogle Scholar
  7. 7.
    Wong SC, Macrae VE, McGrogan P, Ahmed SF. The role of pro-inflammatory cytokines in inflammatory bowel disease growth retardation. J Pediatr Gastroenterol Nutr. 2006;43:144–155.PubMedCrossRefGoogle Scholar
  8. 8.
    Paerregaard A, Uldall Urne F. Anthropometry at the time of diagnosis in Danish children with inflammatory bowel disease. Acta Paediatrica. 2005;94:1682–1683.PubMedCrossRefGoogle Scholar
  9. 9.
    Sawczenko A, Ballinger AB, Savage MO, Sanderson IR. Clinical features affecting final adult height in patients with pediatric-onset Crohn’s disease. Pediatrics. 2006;118:124–129.PubMedCrossRefGoogle Scholar
  10. 10.
    Lesage S, Zouali H, Cezard JP, Colombel JF, Belaiche J, Almer S, Tysk C, O’Morain C, Gassull M, Binder V, Finkel Y, Modigliani R, Gower-Rousseau C, Macry J, Merlin F, Chamaillard M, Jannot AS, Thomas G, Hugot JP, Group E-I, Group E, Group G. CARD15/NOD2 mutational analysis and genotype-phenotype correlation in 612 patients with inflammatory bowel disease. Am J Hum Genet. 2002;70:845–857.Google Scholar
  11. 11.
    Tomer G, Ceballos C, Concepcion E, Benkov KJ, Tomer G, Ceballos C, Concepcion E, Benkov KJ. NOD2/CARD15 variants are associated with lower weight at diagnosis in children with Crohn’s disease. Am J Gastroenterol. 2003;98:2479–2484.PubMedCrossRefGoogle Scholar
  12. 12.
    Amre DK, Lu SE, Costea F, Seidman EG. Utility of serological markers in predicting the early occurrence of complications and surgery in pediatric Crohn’s disease patients. Am J Gastroenterol. 2006;101:645–652.PubMedCrossRefGoogle Scholar
  13. 13.
    Landers CJ, Cohavy O, Misra R, Yang H, Lin YC, Braun J, Targan SR. Selected loss of tolerance evidenced by Crohn’s disease-associated immune responses to auto- and microbial antigens. Gastroenterology. 2002;123:689–699.PubMedCrossRefGoogle Scholar
  14. 14.
    Dubinsky MC, Lin YC, Dutridge D, Picornell Y, Landers CJ, Farrior S, Wrobel I, Quiros A, Vasiliauskas EA, Grill B, Israel D, Bahar R, Christie D, Wahbeh G, Silber G, Dallazadeh S, Shah P, Thomas D, Kelts D, Hershberg RM, Elson CO, Targan SR, Taylor KD, Rotter JI, Yang H, Western Regional Pediatric IBDRA. Serum immune responses predict rapid disease progression among children with Crohn’s disease: immune responses predict disease progression. Am J Gastroenterol. 2006;101:360–367.Google Scholar
  15. 15.
    Vasiliauskas EA, Plevy SE, Landers CJ, Binder SW, Ferguson DM, Yang H, Rotter JI, Vidrich A, Targan SR. Perinuclear antineutrophil cytoplasmic antibodies in patients with Crohn’s disease define a clinical subgroup [see comment]. Gastroenterology. 1996;110:1810–1819.PubMedCrossRefGoogle Scholar
  16. 16.
    Zholudev A, Zurakowski D, Young W, Leichtner A, Bousvaros A. Serologic testing with ANCA, ASCA, and anti-OmpC in children and young adults with Crohn’s disease and ulcerative colitis: diagnostic value and correlation with disease phenotype. Am J Gastroenterol. 2004;99:2235–2241.PubMedCrossRefGoogle Scholar
  17. 17.
    Mow WS, Vasiliauskas EA, Lin YC, Fleshner PR, Papadakis KA, Taylor KD, Landers CJ, Abreu-Martin MT, Rotter JI, Yang H, Targan SR. Association of antibody responses to microbial antigens and complications of small bowel Crohn’s disease [see comment]. Gastroenterology. 2004;126:414–424.PubMedCrossRefGoogle Scholar
  18. 18.
    Forcione DG, Rosen MJ, Kisiel JB, Sands BE. Anti-Saccharomyces cerevisiae antibody (ASCA) positivity is associated with increased risk for early surgery in Crohn’s disease. Gut. 2004;53:1117–1122.PubMedCrossRefGoogle Scholar
  19. 19.
    Vasiliauskas EA, Kam LY, Karp LC, Gaiennie J, Yang H, Targan SR. Marker antibody expression stratifies Crohn’s disease into immunologically homogeneous subgroups with distinct clinical characteristics. Gut. 2000;47:487–496.PubMedCrossRefGoogle Scholar
  20. 20.
    Arnott ID, Landers CJ, Nimmo EJ, Drummond HE, Smith BK, Targan SR, Satsangi J. Sero-reactivity to microbial components in Crohn’s disease is associated with disease severity and progression, but not NOD2/CARD15 genotype. Am J Gastroenterol. 2004;99:2376–2384.PubMedCrossRefGoogle Scholar
  21. 21.
    Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut. 2006;55:749–753.PubMedCrossRefGoogle Scholar
  22. 22.
    Pfefferkorn M, Burke G, Griffiths A, Markowitz J, Rosh J, Mack D, Otley A, Kugathasan S, Evans J, Bousvaros A, Moyer MS, Wyllie R, Oliva-Hemker M, Carvalho R, Crandall W, Keljo D, Walters TD, LeLeiko N, Hyams J. Growth abnormalities persist in newly diagnosed children with crohn disease despite current treatment paradigms. J Pediatr Gastroenterol Nutr. 2009;48:168–174.Google Scholar
  23. 23.
    Markowitz J, Kugathasan S, Dubinsky M, Mei L, Crandall W, LeLeiko N, Oliva-Hemker M, Rosh J, Evans J, Mack D, Otley A, Pfefferkorn M, Bahar R, Vasiliauskas E, Wahbeh G, Silber G, Quiros JA, Wrobel I, Nebel J, Landers C, Picornell Y, Targan S, Lerer T, Hyams J. Age of diagnosis influences serologic responses in children with Crohn’s disease: a possible clue to etiology? Inflamm Bowel Dis. 2009;15:714–719.Google Scholar
  24. 24.
    Dubinsky MC, Kugathasan S, Mei L, Picornell Y, Nebel J, Wrobel I, Quiros A, Silber G, Wahbeh G, Katzir L, Vasiliauskas E, Bahar R, Otley A, Mack D, Evans J, Rosh J, Hemker MO, Leleiko N, Crandall W, Langton C, Landers C, Taylor KD, Targan SR, Rotter JI, Markowitz J, Hyams J, Western Regional Pediatric IBDRA, Pediatric IBDCRG, Wisconsin Pediatric IBDA. Increased immune reactivity predicts aggressive complicating Crohn’s disease in children. Clin Gastroenterol Hepatol. 2008;6:1105–1111.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Division of Pediatric Gastroenterology/Hepatology/Nutrition, James Whitcomb Riley Hospital for ChildrenIndiana University School of MedicineIndianapolisUSA

Personalised recommendations