Published online Apr 14, 2019. doi: 10.3748/wjg.v25.i14.1753
Peer-review started: February 6, 2019
First decision: February 21, 2019
Revised: February 27, 2019
Accepted: March 11, 2019
Article in press: March 12, 2019
Published online: April 14, 2019
We recently reported on a hereditary enteropathy associated with a gene encoding a prostaglandin transporter and referred to as chronic enteropathy associated with SLCO2A1 gene (CEAS). Crohn’s disease (CD) is a major differential diagnosis of CEAS, because these diseases share some clinical features. Therefore, there is a need to develop a convenient screening test to distinguish CEAS from CD.
To examine whether prostaglandin E major urinary metabolites (PGE-MUM) can serve as a biomarker to distinguish CEAS from CD.
This was a transactional study of 20 patients with CEAS and 98 patients with CD. CEAS was diagnosed by the confirmation of homozygous or compound heterozygous mutation of SLCO2A1. We measured the concentration of PGE-MUM in spot urine by radioimmunoassay, and the concentration was compared between the two groups of patients. We also determined the optimal cut-off value of PGE-MUM to distinguish CEAS from CD by receiver operating characteristic (ROC) curve analysis.
Twenty Japanese patients with CEAS and 98 patients with CD were enrolled. PGE-MUM concentration in patients with CEAS was significantly higher than that in patients with CD (median 102.7 vs 27.9 μg/g × Cre, P < 0.0001). One log unit increase in PGE-MUM contributed to 7.3 increase in the likelihood for the diagnosis of CEAS [95% confidence interval (CI) 3.2-16.7]. A logistic regression analysis revealed that the association was significant even after adjusting confounding factors (adjusted odds ratio 29.6, 95%CI 4.7-185.7). ROC curve analysis revealed the optimal PGE-MUM cut-off value for the distinction of CEAS from CD to be 48.9 μg/g × Cre with 95.0% sensitivity and 79.6% specificity.
PGE-MUM measurement is a convenient, non-invasive and useful test for the distinction of CEAS from CD.
Core tip: Chronic enteropathy associated with SLCO2A1 gene (CEAS) is a rare hereditary enteropathy associated with a gene encoding a prostaglandin transporter. It is sometimes difficult to distinguish CEAS from Crohn’s disease (CD), because these diseases share some clinical features. We report the usefulness of prostaglandin E-major urinary metabolites (PGE-MUM) to differentiate CEAS from CD. PGE-MUM concentration was significantly higher in CEAS than in CD, and optimal cut-off value for the distinction of CEAS from CD to be 48.9 μg/g × Cre with sensitivity of 95.0% and specificity of 79.6%. In clinical practice, PGE-MUM measurement might be useful as a screening test for CEAS.