P0501 - Antinuclear Antibodies in Patients Undergoing High-Resolution Esophageal Manometry with Impedance

Susie O.. Lee, MD¹, Saad Irfan, BS², Michael Behanan, BS², Ivanna Morejon, BS², Daniel Rim, MD², Henry P. Parkman, MD^3
1Lewis Katz School of Medicine at Temple University, Los Angeles, CA; ²Lewis Katz School of Medicine at Temple University, Philadelphia, PA; ³Temple University, Strafford, PA

Introduction: High-resolution esophageal manometry with impedance (HREMI) is commonly used during evaluation of patients with symptoms of esophageal dysmotility. Anti-nuclear antibody (ANA) and inflammatory markers are often ordered as part of rheumatologic disorder workup. The utility of routine serologic autoantibody testing in patients undergoing evaluation of esophageal motility dysfunction remains to be studied. Correlating positive ANA with patients’ manometry findings will help clarify whether there is potential benefit in testing patients with no previous ANA testing. This study aimed to 1) determine the prevalence of positive ANA titers in patients undergoing HREMI and 2) assess symptom characteristics of these patients.

Methods: Retrospective chart review was conducted for patients who underwent esophageal function testing and who had an ANA value drawn from Jan 2018 through Dec 2023. We reviewed HREMI reports, esophageal manometry questionnaires, and electronic medical records for ANA, ESR, and CRP. Inflammatory markers and symptoms were correlated with esophageal motility disorders based on the Chicago Classification.

Results: 222 patients (163 females; average age 56.1+13.5; average BMI 30.8+8.2) were included. 87 patients had esophageal motility disorders including ineffective esophageal motility (IEM, n=39), esophagogastric junction outflow obstruction (EGJOO, n=26), and absent contractility (AC, n=16). Table shows results of ANA, ESR, and CRP. ANA titer values were higher in patients with esophageal motility disorders (239.1+680.1) than those without (73.5+218.8) (p=0.0092), particularly AC and IEM. Chest pain and dysphagia severity was greater in patients with esophageal motility disorders than those without (p< 0.05). 39 patients had a positive ANA (>1:160) with a mean titer of 751.8+884.6. Among patients with a positive ANA, the most common esophageal motility disorder was IEM (n=11) and average ANA was highest in patients with AC 1422.9+1647.3 while lowest in patients with EGJOO 480.0+277.1 (p=0.399).

Discussion: ANA positivity and titers were significantly greater in patients with esophageal motility disorders. Among patients with a positive ANA, the most commonly diagnosed esophageal motility disorder was IEM while the highest titer was seen in AC. Patients undergoing HREMI who are diagnosed with IEM or AC may benefit from further testing with ANA and screening for rheumatologic disorders.


Disclosures:


Susie O.. Lee, MD¹, Saad Irfan, BS², Michael Behanan, BS², Ivanna Morejon, BS², Daniel Rim, MD², Henry P. Parkman, MD³. P0501 - Antinuclear Antibodies in Patients Undergoing High-Resolution Esophageal Manometry with Impedance, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.