High ulcerative colitis and Crohn's disease ratio in a population-based registry from Córdoba, Argentina.

BACKGROUND: Few studies have described the epidemiology and clinical behavior of inflammatory bowel disease (IBD) in South America. The aim of this study was to report on the prevalence, phenotype, and treatment of patients with IBD diagnosis in Capital Department of the Province of Córdoba, Argentina. METHODS: Data from adult patients (≥ 18 years-old) with IBD diagnosis that attended 12 public or private centers between 05/2014 and 05/2019 were included in a common registry. RESULTS: A total of 655 patients were included (females: 53.4%). The ratio of ulcerative colitis (UC) (n = 561) to Crohn's disease (CD) (n = 88) was 6.38, with age-adjusted IBD prevalence being 70.1 (95% confidence interval 70.08-70.12) cases/100,000 habitants. Extraintestinal manifestations were diagnosed in 22.8% of patients, and left-side colitis (46%) was the most frequent extension in UC patients. In CD patients, colonic involvement (55.7%) and non-stricturing/non-penetrating behavior (74%) were the most frequent presentations. Biologic therapy was used in 36.4% of CD patients and 9.1% of UC patients (P<0.001). CONCLUSION: In this population registry study, IBD prevalence was similar to that reported in other series in the region. A higher UC/CD ratio was observed due to the lower prevalence of CD compared to similar studies in South America.

Exactitud diagnóstica de anticuerpos antipéptidos de gliadina deamidados / Diagnostic accuracy of antibodies to deamidated gliadin peptides

El objetivo de este trabajo fue evaluar la exactitud diagnóstica de un ELISA para anticuerpos antipéptidos de gliadina deamidados en pacientes con sospecha clínica de enfermedad celíaca (EC) y comparar su rendimiento con anticuerpos antiendomisio (EMA) y antitransglutaminasa tisular (a-Tgt). Se estudiaron 169 pacientes consecutivos (16 a 79 años), sometidos recientemente a biopsia duodenal, a los cuales se les determinó anticuerpos IgA EMA, IgA a-Tgt e IgG/IgA antipéptidos de gliadina deamidados (a-DGP Screen). Sesenta y cinco pacientes tuvieron algún grado de atrofia vellositaria y probable diagnóstico de EC (11 con atrofia vellositaria parcial, 30 subtotal y 24 total) y 104 con estructura vellositaria conservada. La sensibilidad, especificidad y exactitud diagnóstica de a-DGP Screen fue de 86,2%, 98,1% y 93,5% respectivamente, similar a EMA y a-Tgt. Al considerar sólo pacientes con atrofia vellositaria subtotal y total la sensibilidad fue estadísticamente superior en los 3 ensayos (100% para a-DGP Screen, p<0,014). Se observó una excelente concordancia entre a-DGP Screen con EMA (k= 0,99) y con a-Tgt (k = 0,97). El equipo a-DGP Screen demostró una elevada exactitud diagnóstica; su rendimiento fue equivalente a EMA y a-Tgt.

The aim of this study was to evaluate the diagnostic accuracy of an ELISA for antibodies to deamidated gliadin peptides in patients clinically suspected of having celiac disease (CD), and to compare this with antibodies to endomysium (EMA) and tissue transglutaminase (a-Tgt). One hundred and sixty-nine consecutive patients (16 to 79 yo) that had recently underwent small-bowel biopsy were included; serum samples were obtained for the measurement of IgA EMA, IgA a-Tgt and IgG/IgA antideamidated gliadin peptides (a-DGP Screen) antibodies. Sixty-five patients had some degree of villous atrophy with probable diagnostic of CD (11 partial, 30 subtotal and 24 total villous atrophy); 104 individuals had normal villous architecture. The sensitivity, specificity, and accuracy of a-DGP Screen were 86.2%, 98.1% and 93.5% respectively, similar to EMA or a-Tgt. When only patients with subtotal and total villous atrophy were considered, the sensitivity was statistically higher for the 3 tests (100% for a-DGP Screen, p<0.014). An excellent agreement was observed among a-DGP Screen with EMA (κ= 0,99) and with a-Tgt (κ = 0,97). The a-DGP Screen assay showed a high diagnostic accuracy with a performance equivalent to EMA or a-Tgt.