Investigation of potential early Histologic markers of pediatric inflammatory bowel disease

BMC Gastroenterology

Vivekanand Singh⁵  Valentina Shakhnovich³  Julia M. Bracken⁴  Nancy A. Neilan¹  Amanda D. Deacy²  Craig A. Friesen⁴  Julie A. Bass⁴ 

[1] Division of Infectious Disease, Children’s Mercy Hospitals & Clinics, 2401 Gillham Road, Kansas City 64108, MO, USA;Division of Developmental and Behavioral Sciences, Children’s Mercy Hospitals & Clinics, 2401 Gillham Road, Kansas City 64108, MO, USA;Division of Clinical Pharmacology, Toxicology, and Therapeutic Innovation, Children’s Mercy Hospitals & Clinics, 2401 Gillham Road, Kansas City 64108, MO, USA;Division of Gastroenterology, Children’s Mercy Hospitals & Clinics, 2401 Gillham Road, Kansas City 64108, MO, USA;Department of Pathology, Children’s Mercy Hospitals & Clinics, 2401 Gillham Road, Kansas City 64108, MO, USA

关键词: MMP-9;    TNF-α;    Eosinophils;    Inflammatory bowel disease;   

Others  :  1234381
DOI  :  10.1186/s12876-015-0359-2

 received in 2014-06-02, accepted in 2015-09-25,  发布年份 2015

【 摘 要 】

Background

Early manifestations of pediatric inflammatory bowel disease (IBD) can be relatively nonspecific. Initial mucosal biopsies may not be conclusive, delaying the diagnosis until subsequent biopsies demonstrate typical histologic features of IBD. We hypothesized that certain inflammatory cell types may be utilized as early histologic indicators of IBD in children.

Methods

A retrospective analysis compared histologic findings from initially inconclusive or negative endoscopic studies in 22 patients who were subsequently diagnosed with IBD (after diagnostic endoscopy) to those of 20 comparison patients with functional abdominal pain matched for age, gender, and study type. A pediatric pathologist, blinded to study group, reviewed biopsies for histologic abnormalities. Eosinophil densities were obtained from the stomach, duodenum, and rectosigmoid areas. Immunohistochemistry (IHC) staining for tumor necrosis factor-α (TNF-α) and matrix metalloproteinase-9 (MMP-9) was performed on the stomach and rectosigmoid areas.

Results

Gastritis and colonic crypt distortion were present in the IBD group at a greater rate (61 % vs. 22 %, p = 0.020; 34 % vs. 4 %, p = 0.008, respectively). Peak and mean eosinophil densities in the rectosigmoid area were greater in the IBD group (17.0/hpf vs. 5.0/hpf, p = 0.0063; 12.3/hpf vs. 4.2/hpf, p = 0.0106, respectively). TNF-α and MMP-9 staining did not reveal any significant differences.

Conclusions

Our data suggests that significantly greater inflammation in the stomach, crypt distortion in the colon, and eosinophilia in the rectosigmoid distinguished the IBD group from the comparison group at the time of the initial endoscopic evaluation.

【 授权许可】

   
2015 Bass et al.

【 图 表 】

Fig. 1.

Fig. 2.

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