Quantitative distribution of tissue eosinophils in the gastrointestinal tract of children with functional abdominal pain disorders compared to normal references and inflammatory bowel disease

Abdominal pain;Child;Eosinophils;Functional gastrointestinal disorder;Inflammatory bowel disease;610

의과대학 의학과 ;

University:서울대학교 대학원

关键词: Abdominal pain;    Child;    Eosinophils;    Functional gastrointestinal disorder;    Inflammatory bowel disease;    610;   

Others  :  http://s-space.snu.ac.kr/bitstream/10371/142346/1/000000149618.pdf

美国|英语

来源: Seoul National University Open Repository

【 摘 要 】

Introduction: Functional abdominal pain disorders (FAPDs) are common in children and adolescents. However, the accurate pathogenesis of FAPDs is not yet known. Recently, micro-inflammation, particularly eosinophilia associated with the gastrointestinal (GI) tract has been suggested as the pathophysiology observed in several GI disorders. We aimed to evaluate eosinophilic infiltration throughout the GI tract in children and adolescents with FAPDs, compared to those diagnosed with inflammatory bowel diseases (IBD) and to normal reference values.Methods: We included 56 children with FAPDs, 52 children with Crohn’s disease, and 23 children with ulcerative colitis. All subjects underwent esophagogastroduodenoscopic and colonoscopic examination with biopsies performed on the same day. Tissue eosinophil counts were assessed in 10 regions throughout the GI tract between the stomach and the rectum. Tissue eosinophil counts of children with FAPDs were compared to those obtained from children with IBD or normal pathological references from each of the 10 regions assessed. To minimize the effects of regional inflammation of IBD itself, eosinophil counts were further analyzed after eliminating segments that endoscopically showed macroscopic involvement.Results: Eosinophil counts of the stomach (gastric antrum), small bowel (duodenum, terminal ileum), and colon (cecum, ascending colon) were observed to be significantly higher in children with FAPDs compared to normal reference values. Eosinophil counts of the stomach (gastric antrum and body) and the entire colon between the cecum and the rectum were observed to be significantly higher in children presenting with IBD than in those presenting with FAPDs. After selecting histopathological slides of GI segments that endoscopically did not show macroscopic involvement, comparison of tissue eosinophil counts between children with IBDs and those with FAPDs revealed that eosinophil counts of the stomach (gastric body), and the colon (cecum, descending and sigmoid colon, and the rectum) were also significantly higher in children presenting with IBD than those presenting with FAPDs. A comparison between children with FAPDs and those with IBD before and after selecting the macroscopically unaffected GI segments in the IBD groups showed that there were no significant differences in eosinophil counts of the small bowel (duodenum, terminal ileum).Conclusions: Significantly high eosinophil counts of the stomach and colon showed a definite order in terms of the disease entity IBD, followed by FAPDs, and normal controls, even after selecting uninvolved GI segments in patients with IBD. Therefore, eosinophilic infiltration of the GI tract might be associated with the intrinsic pathogenesis of both FAPDs and IBD in children.