Background-Perinuclear antineutrophil cytoplasmic autoantibodies (pANCA) are a well recognised marker for ulcerative colitis. Antibodies to oligomannosidic epitopes of the yeast Saccharomyces cerevisiae (ASCA) are a new marker associated with Crohn's disease. Aims-To assess the value of detecting pANCA and/or ASCA for the diagnosis of ulcerative colitis and Crohn's disease. Methods-Serum samples were obtained from 100 patients with Crohn's disease, 101 patients with ulcerative colitis, 27 patients with other miscellaneous diarrhoeal illnesses, and 163 healthy controls. Determination of pANCA and ASCA was performed using the standardised indirect immunofluorescence technique and an ELISA, respectively. Results-The combination of a positive pANCA test and a negative ASCA test yielded a sensitivity, specificity, and positive predictive value of 57%, 97%, and 92.5% respectively for ulcerative colitis. The combination of a positive ASCA test and a negative pANCA test yielded a sensitivity, specificity, and positive predictive value of 49%, 97%, and 96% respectively for Crohn's disease. Among patients with miscellaneous non-inflammatory bowel disorders, three were ASCA positive and two were pANCA positive. One control was ASCA positive. The presence of ASCA in patients with Crohn's disease was associated with small bowel involvement. Conclusion-ASCA and pANCA are strongly associated with Crohn's disease and ulcerative colitis, respectively. Combination of both tests could help the diagnosis of inflammatory bowel disease. (Gut 1998;42:788-791)
ASCA in 20% of healthy first degree relatives of patients with Crohn's disease suggest that these antibodies might be a subclinical marker for Crohn's disease in families. Whether ASCA reflect environmental or genetic factors or a combination of both is unknown.
Extraintestinal manifestations occurred at lower frequency in elderly-onset compared with pediatric-onset patients. In both age populations, presence of EIM at diagnosis independently increased the need for corticosteroid and immunosuppressive treatment.
A 2-year-old male ferret was presented with central nervous system signs. Computed tomography (CT) of the brain revealed a well-defined contrast-enhancing lesion on the rostral forebrain that appeared extraparenchymal. Surgical excision of the mass was performed and the ferret was euthanised during the procedure. Histopathology of the excised mass showed multiple meningeal nodular lesions with infiltrates of epithelioid macrophages, occasionally centred on degenerated neutrophils and surrounded by a broad rim of plasma cells, features consistent with pyogranulomatous meningitis. The histopathological features in this ferret were similar to those in cats with feline infectious peritonitis. Definitive diagnosis was assessed by immunohistochemistry, confirming a ferret systemic coronavirus (FSCV) associated disease. This is the first case of coronavirus granuloma described on CT-scan in the central nervous system of a ferret.
Liposarcomas are rare malignant tumors of the adipose tissue which are well described in humans and animals. Wide margin excision is the recommended treatment for these infiltrative, slow to metastasize tumors. Primary liposarcoma with ocular localization is a very rare tumor in humans, dogs and cats. This report describes, for the first time, a palpebral liposarcoma in a 18-month old guinea pig that presented with a large palpebral mass and purulent discharge in the right eye. The ophthalmic evaluation revealed a one-centimeter infiltrating subcutaneous mass within the upper eyelid, a severe chemosis and hyperhemia of the palpebral and bulbar conjunctiva of the right eye. Cytologic examination of the mass revealed only epithelial cells. Histologic examination interpreted the lesion as a xanthogranulomatous reaction possibly secondary to meibomian gland rupture or inflammation. One month later, the mass had increased in size and the animal had stopped eating. Euthanasia was performed and a large biopsy was submitted for another histological examination. Histopathology revealed polygonal to rounded cells with a large, empty intracytoplasmic vacuole, and an ovoid, eccentrically located nucleus. The histology was consistent with a well-differentiated liposarcoma. Given the unusual location, immunohistochemistry was performed to ascertain the mesenchymal nature of the neoplasm.
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