Inflammatory bowel diseases in Indo-Canadians
Previous studies have demonstrated that some antineutrophil cytoplasmic autoantibodies (ANCA) may be detected in patients with inflammatory bowel disorders, particularly in those with ulcerative colitis. Recently, in a prospective study of 500 Canadian patients with inflammatory bowel disease (IBD) who were evaluated at the University of British Columbia, 38.8% were positive for ANCA – 66.3% with ulcerative colitis and 11.9% with Crohn’s disease. In addition, this seromarker persisted in patients with ulcerative colitis, even after proctocolectomy. Occasionally, this seromarker may be detected with other forms of IBD, specifically microscopic forms of colitis, including collagenous or lymphocytic colitis, with or without celiac disease. Although a specific subclass, the atypical perinuclear ANCA (p-ANCA), are often present if there is colonic disease, occasionally patients with Crohn’s disease localized only to the small bowel may also be positive. In a more recent study, the presence of a relatively unique subclass, the so-called cytoplasmic ANCA (c-ANCA) typically reported in Wegener’s granulomatosis, was observed in a group of 18 patients with extensive colitis. This subclass was not common, occurring in an estimated 2% of patients with IBD at this centre. Interestingly, significant numbers of patients with c-ANCA (ie, almost half) were Indo-Canadians.
To evaluate these disorders further in the Indo-Canadian population of metropolitan Vancouver, British Columbia, the clinical features of a cohort of 84 patients were prospec- tively evaluated. In this analysis, characteristics of the population cohort and features of their diseases were detailed. Also, the detection rates of different types of ANCA within this cohort were defined.
The Indo-Canadian population in metropolitan Vancouver is geographically heterogeneous in its origins. In addition to those born in Canada, individuals have migrated from the Indian subcontinent and from other countries, particularly from East African nations such as Uganda. As a result, the opportunity to explore the geographical impact on this population was provided. Finally, seropositive and seronegative status were compared in Indo-Canadians with IBD.
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