Presence and diagnosis of amebic infestation in Turkish patients with active ulcerative colitis

Abstract Background It is difficult to definitively diagnose acute amebiasis, particularly when this condition is superimposed on inflammatory bowel disease. Our goals in this study were to determine the prevalence of amebiasis in individuals with active ulcerative colitis, and to identify clinical...

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Published in:European journal of internal medicine 2009-09, Vol.20 (5), p.545-547
Main Authors: Ozin, Yasemin, Kilic, Mesut Zeki Yalın, Nadir, Isılay, Tayfur, Oyku, Ertas, Arzu, Ulker, Aysel, Sahin, Burhan
Format: Article
Language:English
Subjects:
Adult
Amebiasis
Antigens, Protozoan - isolation & purification
Cohort Studies
Colitis, Ulcerative - microbiology
Dysentery, Amebic - diagnosis
Dysentery, Amebic - epidemiology
Entamoeba histolytica
Entamoeba histolytica - immunology
Enzyme-Linked Immunosorbent Assay
Feces - microbiology
Female
Humans
Internal Medicine
Male
Middle Aged
Predictive Value of Tests
Prevalence
Risk Factors
Turkey
Ulcerative colitis
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Summary:Abstract Background It is difficult to definitively diagnose acute amebiasis, particularly when this condition is superimposed on inflammatory bowel disease. Our goals in this study were to determine the prevalence of amebiasis in individuals with active ulcerative colitis, and to identify clinical and laboratory parameters that are of value for diagnosing amebiasis in this patient group. Methods The subjects were 111 patients (76 women, 35 men) with confirmed active ulcerative colitis who attended our hospital's Inflammatory Bowel Disease Outpatient Clinic between May 2002 and March 2006. In each case, a detailed medical history was collected, blood samples were tested for inflammatory markers, and stool samples were evaluated for presence of amebae using an Enzyme-Linked Immunosorbent Assay (ELISA) for detection of Entamoeba histolytica antigen. The clinical and laboratory variables for the ELISA-positive and ELISA-negative groups were compared. Results Amebiasis was detected in 35 (31.5%) of the subjects. Patient age, disease duration, endoscopic activity index, serum C-reactive protein level, and white blood cell count were not useful for diagnosing amebiasis in this patient group. Conclusions Given the high rate of amebiasis observed in our patients with active ulcerative colitis, we recommend that, in Turkey any individual with ulcerative colitis who presents with symptoms of disease activation should be tested for ameba using antigen detection kits. A high index of suspicion is especially important in any region where E. histolytica is endemic.
ISSN:0953-6205
1879-0828
DOI:10.1016/j.ejim.2009.05.014