Inflammatory bowel disease-specific autoantibodies in HLA-B27-associated spondyloarthropathies: increased prevalence of ASCA and pANCA.

AIMS: An association between inflammatory bowel disease (IBD) and spondyloarthropathies (SpA) has repeatedly been reported. The aim of the present study was to investigate whether serologic markers of IBD, e.g. antibodies against Saccharomyces cerevisiae (ASCA), antibodies against exocrine pancreas (PAB) and perinuclear antineutrophil cytoplasmic antibodies (pANCA) are present in HLA-B27-associated SpA. METHODS: 87 patients with HLA-B27-positive SpA and 145 controls were tested for ASCA, PAB and pANCA employing ELISA or indirect immunofluorescence, respectively. Antibody-positive patients were interviewed regarding IBD-related symptoms using a standardized questionnaire. RESULTS/CONCLUSION: When compared to the controls, ASCA IgA but not ASCA IgG levels were significantly increased in patients with SpA, in particular in ankylosing spondylitis (AS) and undifferentiated SpA (uSpA). pANCA were found in increased frequency in patients with SpA whereas PAB were not detected. The existence of autoantibodies was not associated with gastrointestinal symptoms but sustains the presence of a pathophysiological link between bowel inflammation and SpA.

Severe diarrhea associated with Arcobacter butzleri.

Two patients with chronic disease (diabetes mellitus type I, hyperuricemia and alcohol abuse, respectively) were hospitalized with persistent diarrhea and severe abdominal cramps. Using routine methods, the only pathogen isolated in stool specimens was Arcobacter butzleri. In both cases acute symptoms subsided quickly after antibiotic therapy. After termination of antibiotic treatment, Arcobacter butzleri could no longer be detected in stool specimens. Although very little is known about the clinical significance of Arcobacter butzleri infections in humans, it is highly likely that in both cases Arcobacter butzleri played a major causative role in acute disease.