BACKGROUND: The pathogenesis of Ulcerative Colitis (UC) and its extraintestinal manifestations remain uncertain, although involvement of the immune system is emphasized. The likely importance of neutrophils is demonstrated by detection of the antineutrophil cytoplasmic antibody (ANCA) in this inflammatory bowel disease. Pyoderma Gangrenosum (PG) is an idiopathic skin condition and a rare cutaneous manifestation of UC. ANCA has also been reported in the latter dermatosis. OBJECTIVES: To invetigate the relationship between clinical features of UC and the appearance of PG and its association with ANCA. PATIENTS AND METHODS: ANCA was determined in sera from eight patients with PG. Four out of eight patients had pyoderma gangrenosum associated-UC, and in four cases no identified systemic disease was associated. RESULTS: The search for ANCA yielded negative results in sera from all four patients with pyoderma not associated with systemic disease. Two cases with active and extensive colitis associated with PG and primary sclerosing cholangitis (PSC) were positive for ANCA. Sera from two other patients with both UC and PG had negative test results. CONCLUSIONS: The presence of ANCA in patients with PG associated with UC and PSC suggests that its association with PSC is responsible for ANCA positivity in this subset of patients.
antibodies; antineutrophil cytoplasmic; cholangitis; sclerosing; pyoderma gangrenosum; colitis, ulcerative
