Serological markers predict early complications in pediatric Crohn's

Serum anti-Saccharomyces cervisiae measured close to diagnosis can determine the occurrence of early complications in pediatric Crohn's disease, shows this month's American Journal of Gastroenterology.

Many Crohn's disease patients develop complications, and require surgery, often repeatedly and at variable instances.

Identifying serological markers that determine their early or repeated manifestation can enable implementing more aggressive preventive strategies.

Dr Ernest Seidman and colleagues studied the ability of serological markers for predicting complications or requirement for surgery.

The researchers included a pediatric cohort of Crohn's disease patients identified between 1996 and 1998.

Serum anti-Saccharomyces cervisiae, and perinuclear antineutrophil cytoplasmic antibodies were assayed close to diagnosis.

At diagnosis and follow-up, information was acquired on demographic and clinical features of disease.

22% acquired one or more Crohn's disease related complication

American Journal of Gastroenterology

The researchers studied the relation between serum anti-Saccharomyces cervisiae and clinical events using adjusted Cox-proportional hazards modeling.

The relative rates of recurrent clinical events according to the marker measures were compared.

The mean age at diagnosis was 11 years.

Among 139 patients, 26% and 22% acquired one or more Crohn's disease related surgery or complication, respectively.

The team found that time to occurrence of the first complication was lower among serum anti-Saccharomyces cervisiae positive IgA and IgG patients.

Time to occurrence of first complication was also higher among those with higher serum anti-Saccharomyces cervisiae-IgA titers.

The researchers observed that rates of recurrent complications were higher among those positive or with higher serum anti-Saccharomyces cervisiae titers.

Serum anti-Saccharomyces cervisiae did not predict time to undergoing surgery independent of complications.

The team noted that serum anti-Saccharomyces cervisiae was unrelated to the occurrence of recurrent surgeries.

Dr Seidman's team concluded, “Our study shows that serum anti-Saccharomyces cervisiae measured close to diagnosis can determine the occurrence of early complications in pediatric Crohn's disease.”

“Preventive treatment targeted toward these susceptible patients could potentially modify the disease course.”