Anti-Saccharomyces cerevisiae antibody is not useful to differentiate between  Crohn's disease  and intestinal tuberculosis in India

Context : Clinical, endoscopic, radiological and histological parameters of intestinal tuberculosis (IT) and Crohn′s disease (CD) are so similar that differentiation between these two diseases, which require different treatment, is difficult. Anti- Saccharomyces cerevisiae antibody (ASCA), which is often present in the sera of patients with CD, may be potentially useful to differentiate CD from IT.
Aim : To evaluate the role of enzyme-linked immunosorbent assay test for ASCA in serum in differentiating CD from intestinal tuberculosis.
Settings and Design : Prospective case-control study.
Materials and Methods: Sixteen patients with IT, 16 CD, 36 UC diagnosed using standard parameters and 12 controls (11 healthy subjects and one with colonic carcinoma) were tested for IgG ASCA in serum.
Statistical Analysis Used : Categorical variables were analyzed using Chi-square test with Yates′ correction, as applicable. Continuous variables were analyzed using Mann-Whitney U test.
Results : Eight of 16 (50%) patients with IT, 10 of 16 with CD (62%), nine of 35 with UC (26%) and one of 12 controls tested positive for ASCA in serum. Though the frequency of ASCA in serum was comparable among patients with IT and CD (8/16 vs. 10/16, P = ns), IT and UC (8/16 vs. 9/35, P =ns), CD and UC (10/16 vs. 9/35, P =ns), its frequency in CD or IT but not in UC was higher than healthy controls ( P < 0.01).
Conclusions : Serum ASCA is unlikely to be useful to differentiate between CD and IT in India.

Keywords
Crohn′s disease, gastrointestinal tuberculosis, tropical country, ulcerative colitis