Guatibonza-García V, Gaete PV, Pérez-Londoño A, Puerto-Baracaldo DK, Gutiérrez-Romero SA, Mendivil CO, Tapias M. Poor performance of anti-mitochondrial antibodies for the diagnosis of primary biliary cholangitis in female Colombian patients: A single-center study. World J Gastroenterol 2021; 27(29): 4890-4899 [PMID: 34447233 DOI: 10.3748/wjg.v27.i29.4890]
Corresponding Author of This Article
Monica Tapias, MD, Attending Doctor, Department of Hepatology, Fundación Santa Fe de Bogotá, Carrera 7 No.117-15, Bogotá 110111, Colombia. monictapias@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Aug 7, 2021; 27(29): 4890-4899 Published online Aug 7, 2021. doi: 10.3748/wjg.v27.i29.4890
Poor performance of anti-mitochondrial antibodies for the diagnosis of primary biliary cholangitis in female Colombian patients: A single-center study
Valentina Guatibonza-García, Paula Valentina Gaete, Agustín Pérez-Londoño, Danna Kathalina Puerto-Baracaldo, Sebastián Antonio Gutiérrez-Romero, Carlos O Mendivil, Monica Tapias
Valentina Guatibonza-García, Paula Valentina Gaete, Agustín Pérez-Londoño, Danna Kathalina Puerto-Baracaldo, Sebastián Antonio Gutiérrez-Romero, Monica Tapias, School of Medicine, Universidad de los Andes, Bogotá 110111, Colombia
Carlos O Mendivil, Section of Endocrinology, Department of Internal Medicine, Fundación Santa Fe de Bogotá, Bogotá 110111, Colombia
Monica Tapias, Department of Hepatology, Fundación Santa Fe de Bogotá, Bogotá 110111, Colombia
Author contributions: Tapias M and Mendivil CO conceived and supervised the study execution, and took part in the data analysis; Guatibonza-García V, Gaete PV, Pérez-Londoño A, Puerto-Baracaldo DK, and Gutiérrez-Romero SA participated in data collection, analysis, and interpretation; All authors drafted the manuscript and revised the article critically for important intellectual content.
Institutional review board statement: The study was reviewed and approved by the Research Ethics Committee of the Universidad de los Andes.
Informed consent statement: Being a retrospective analysis of anonymized data, this study was exempt from informed consent requirement by the Research Ethics Committee of the Universidad de los Andes.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: Data are available from the corresponding author upon written request from a qualified researcher.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Monica Tapias, MD, Attending Doctor, Department of Hepatology, Fundación Santa Fe de Bogotá, Carrera 7 No.117-15, Bogotá 110111, Colombia. monictapias@yahoo.com
Received: January 29, 2021 Peer-review started: January 29, 2021 First decision: March 29, 2021 Revised: April 3, 2021 Accepted: April 22, 2021 Article in press: April 22, 2021 Published online: August 7, 2021 Processing time: 187 Days and 7.4 Hours
ARTICLE HIGHLIGHTS
Research background
Primary biliary cholangitis (PBC) is a rare but serious and severely limiting autoimmune liver disease. Diagnosis of PBC is complicated by the different diagnostic performance of different autoantibodies in different populations.
Research motivation
There are limited data on the performance of autoantibodies for PBC diagnosis among Hispanic/Latino populations.
Research objectives
To assess the diagnostic performance of anti-mitochondrial antibodies (AMAs), anti-nuclear antibodies (ANAs), anti-smooth muscle antibodies (ASMAs), plasma immunoglobulin (Ig) M and plasma IgG for the diagnosis of histologically-confirmed PBC among female Colombian patients.
Research methods
We studied 43 PBC cases and 42 controls in whom PBC was ruled out. All antibodies were measured using immunofluorescence or enzyme-linked immunosorbent assay within 1 year of the index biopsy. A sensitivity analysis was performed using pathology + elevated alkaline phosphatase to define case-control status. Patients with viral or alcoholic hepatitis were excluded.
Research results
The sensitivity of ANA was only 44.2%, specificity was 76.2%. No individual antibody or antibody combination displayed an acceptable combination of sensitivity and specificity, but the combination of positive AMA and positive ASMA had a very high specificity. IgM had particularly high specificity and positive predictive value.
Research conclusions
We found a remarkably high prevalence of AMA-negative PBC among female Colombian patients. IgM served not only as a marker of PBC, but also as a marker of liver fibrosis.
Research perspectives
It is urgent to find a good marker for AMA-negative PBC, especially for Hispanic/Latino populations.
