A Study on inflammatory bowel disease and role of serological markers.

Chezhian, A (2011) A Study on inflammatory bowel disease and role of serological markers. Masters thesis, Kilpauk Medical College, Chennai.


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INTRODUCTION : Inflammatory bowel disease is one of the chronic debilitating illnesses and is a challenge to the treating gastroenterologist and to the patient. The most common form of inflammatory bowel disease in India is ulcerative colitis. During 1960’s all the cases of chronic bloody diarrheas were diagnosed as amebic colitis or infective colitis. Tandon and chuttani et al first described ulcerative colitis in india. There are lots of articles published from south India also cites its increasing incidence. The incidence of ulcerative colitis varies from 1.2 to 20 per 100,000 person-years and its prevalence from 40 to 246 per 100,000 persons in studies conducted across the world. Ulcerative colitis begins in rectal mucosa circumferentially and spreads to involve the proximal portions continuously without any skip areas. The inflammation involves mucosa and submucosa and no transmural involvement which is a feature of crohns disease. There are lots of diseases that can mimic ulcerative colitis from the commonly occurring infections to the rare forms of atypical colitis. Inflammatory bowel diseases (IBD) are subdivided into ulcerative colitis (UC) and Crohn’s disease (CD). Several lines of evidence suggest that CD and UC are different diseases. However, some patients (10–12%) cannot be easily classified into either and a final diagnosis of indeterminate colitis is made. Making an earlier, more accurate diagnosis of IBD is important as the management of CD and UC is different, especially when surgery is planned. A search for serological tests to differentiate CD from UC has been underway for a long time7. An ideal serological marker should have high sensitivity, high specificity, and high predictive values, AIM OF THE STUDY : 1. To study the environmental and psychosocial factors associated with ulcerative colitis. 2. To study the clinical presentations, natural history and extraintestinal manifestations of ulcerative colitis. 3. To study the usefulness of panel of serological markers in the diagnosis of ulcerative colitis. 4. To study any correlation of serological markers with clinical presentation, disease severity and natural course of the disease. 5. To study the effects of therapy on serological markers and any correlation with poor response to therapy. CONCLUSION : Positive p ANCA along with negative ASCA can be used as an additional diagnostic marker in ulcerative colitis. Positive p ANCA along with negative ASCA is a marker of disease extent. Positive p ANCA along with negative antigoblet cell antibodies can predict poor response to drug therapy. Positive p ANCA can predict multiple extraintestinal system involvement warrants longterm followup. Positive p ANCA along with negative antigoblet cell antibodies can predict chronic continuous course of ulcerative colitis. Extraintestinal manifestations are common and rheumatologic manifestations were the most common of it. Psychological factors have a definitive precipitating role in ulcerative colitis.

Item Type: Thesis (Masters)
Uncontrolled Keywords: inflammatory bowel disease ; serological markers.
Subjects: MEDICAL > Gastroenterology
Depositing User: Kambaraman B
Date Deposited: 14 Jul 2017 02:48
Last Modified: 14 Jul 2017 02:48
URI: http://repository-tnmgrmu.ac.in/id/eprint/1605

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