TY - JOUR
T1 - Prevalence and clinical correlates of antinuclear antibody in patients with gastroparesis
AU - for the NIDDK Gastroparesis Clinical Research Consortium
AU - Parkman, Henry P.
AU - Van Natta, Mark L.
AU - Makol, Ashima
AU - Grover, Madhusudan
AU - McCallum, Richard W.
AU - Malik, Zubair
AU - Koch, Kenneth L.
AU - Sarosiek, Irene
AU - Kuo, Braden
AU - Shulman, Robert J.
AU - Farrugia, Gianrico
AU - Miriel, Laura
AU - Tonascia, James
AU - Hamilton, Frank
AU - Pasricha, Pankaj J.
AU - Abell, Thomas L.
N1 - Publisher Copyright:
© 2021 John Wiley & Sons Ltd.
PY - 2022/5
Y1 - 2022/5
N2 - Background: Autoimmunity may play a role in the pathogenesis of gastroparesis in a subset of patients. Antinuclear antibody (ANA) testing is often used to screen for autoimmune disorders. Aims: 1) Determine prevalence of a positive ANA in patients with gastroparesis; 2) Describe characteristics of idiopathic gastroparesis patients with positive ANA. Methods: Patients were assessed with gastric emptying scintigraphy (GES), symptom assessment via Patient Assessment of Upper GI Symptoms [PAGI-SYM], and blood tests—ANA, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP). Results: Positive ANA was seen in 148 of 893 (17%) patients with gastroparesis, being similar in idiopathic (16% of 536 patients), T1DM (16% of 162), T2DM (18% of 147), and postfundoplication (19% of 48 patients) gastroparesis. Among 536 patients with idiopathic gastroparesis, ANA titer 1:40–1:80 was seen in 33 (6%) patients, 1:160–1:320 in 36 (7%) patients, and ≥1:640 in 17 (3%) patients. Increasing ANA titer was associated with female gender (p = 0.05), Hispanic ethnicity (p = 0.02), comorbid rheumatoid arthritis (p = 0.02), systemic sclerosis (p = 0.004), and elevated ESR (p = 0.007). ANA positivity was associated with lower total GCSI (p = 0.007) and lower nausea/vomiting subscale (p = 0.0005), but not related to gastric emptying. Conclusions: The prevalence of a positive ANA in patients with gastroparesis was high at ~17% and did not differ significantly based on etiology. In idiopathic patients, ANA positivity was associated with rheumatoid arthritis, systemic sclerosis, and elevated ESR. ANA-positive gastroparesis represents a subset who often have other autoimmune symptoms or disorders, but less severe nausea and vomiting.
AB - Background: Autoimmunity may play a role in the pathogenesis of gastroparesis in a subset of patients. Antinuclear antibody (ANA) testing is often used to screen for autoimmune disorders. Aims: 1) Determine prevalence of a positive ANA in patients with gastroparesis; 2) Describe characteristics of idiopathic gastroparesis patients with positive ANA. Methods: Patients were assessed with gastric emptying scintigraphy (GES), symptom assessment via Patient Assessment of Upper GI Symptoms [PAGI-SYM], and blood tests—ANA, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP). Results: Positive ANA was seen in 148 of 893 (17%) patients with gastroparesis, being similar in idiopathic (16% of 536 patients), T1DM (16% of 162), T2DM (18% of 147), and postfundoplication (19% of 48 patients) gastroparesis. Among 536 patients with idiopathic gastroparesis, ANA titer 1:40–1:80 was seen in 33 (6%) patients, 1:160–1:320 in 36 (7%) patients, and ≥1:640 in 17 (3%) patients. Increasing ANA titer was associated with female gender (p = 0.05), Hispanic ethnicity (p = 0.02), comorbid rheumatoid arthritis (p = 0.02), systemic sclerosis (p = 0.004), and elevated ESR (p = 0.007). ANA positivity was associated with lower total GCSI (p = 0.007) and lower nausea/vomiting subscale (p = 0.0005), but not related to gastric emptying. Conclusions: The prevalence of a positive ANA in patients with gastroparesis was high at ~17% and did not differ significantly based on etiology. In idiopathic patients, ANA positivity was associated with rheumatoid arthritis, systemic sclerosis, and elevated ESR. ANA-positive gastroparesis represents a subset who often have other autoimmune symptoms or disorders, but less severe nausea and vomiting.
KW - autoimmune
KW - gastric emptying
KW - idiopathic gastroparesis
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U2 - 10.1111/nmo.14270
DO - 10.1111/nmo.14270
M3 - Article
C2 - 34595805
AN - SCOPUS:85116392877
SN - 1350-1925
VL - 34
JO - Neurogastroenterology and Motility
JF - Neurogastroenterology and Motility
IS - 5
M1 - e14270
ER -