Inflammatory bowel disease with cytoplasmic-staining antineutrophil cytoplasmic antibody and extensive colitis

A cohort of 18 patients with inflammatory bowel disease who were characterized by the presence of cytoplasmic-staining antineutrophil cytoplasmic antibody (cANCA) and extensive colitis is reported. Almost half were Indo-Canadians, and atypical perinuclear-staining antineutrophil cytoplasmic antibody was also detected in five (28%), similar to the detection rate for Crohn's disease and other less commonly detected forms of colitis, such as lymphocytic or collagenous colitis. Careful pathological review of all endoscopic biopsies and surgically resected colonic tissues did not reveal evidence of vasculitis or so-called 'palisading' granulomas, which is a typical pathological change of Wegener's granulomatosis, an entity that has been traditionally characterized by the detection of cANCA. This report describes 18 patients with extensive colitis and the seromarker cANCA but without clinical features or histological evidence of vasculitis.