FOCAL ENHANCED GASTRITIS AND MACROPHAGE MICROAGGREGATES IN THE GASTRIC MUCOSA: potential role in the differential diagnosis between Crohn’s disease and ulcerative colitis

Arquivos de Gastroenterologia

Marcia Henriques De MagalhÃes-costa¹  Beatriz Ribeiro Dos Reis¹  Vera Lúcia Antunes Chagas¹  Tiago Nunes¹  Heitor Siffert Pereira De Souza¹  Cyrla Zaltman¹ 

关键词: Crohn’s disease;    Ulcerative colitis;    Gastritis;    Macrophages;    Helicobacter pylori;    Doença de Crohn;    Colite ulcerativa;    Gastrite;    Macrofagos;    Helicobacter pylori;   

DOI  :  10.1590/S0004-28032014000400003

来源: SciELO

【 摘 要 】

Context and Objectives Focally enhanced gastritis and macrophage microaggregates are found in the upper gastrointestinal involvement of Crohn’s disease, and may reflect an underlying defective innate immunity. These features, however, are also described in patients with Helicobacter pylori infection. The role of these gastric abnormalities in the diagnosis of Crohn’s disease was assessed in a population with high prevalence of H. pylori infection. Methods Thirty-seven Crohn’s disease, 26 ulcerative colitis, and 30 control patients were included. The H. pylori status was evaluated by the rapid urease test and histology. The presence of focally enhanced gastritis and macrophage microaggregates was recorded. Results Focally enhanced gastritis was present in 24% of Crohn’s disease patients, 4% of ulcerative colitis patients and 11.5% of controls, presenting an overall sensitivity and specificity for Crohn’s disease of 24% and 88%, respectively. Macrophage microaggregates were found in all groups, but were only detected in ulcerative colitis and controls in association with H. pylori infection, with an overall sensitivity and specificity for Crohn’s disease of 61% and 69%, respectively. In the absence of H. pylori infection, focally enhanced gastritis and macrophage microaggregates were significantly associated with Crohn’s disease (P<0.02 and P = 0.001 respectively). Conclusions Focally gastritis and macrophage microaggregates are suggestive of Crohn’s disease only in H. pylori-negative specimens. HEADINGS - Crohn’s disease. Ulcerative colitis. Gastritis. Macrophages. Helicobacter pylori.

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