TY - JOUR
T1 - Investigation of potential early Histologic markers of pediatric inflammatory bowel disease
AU - Bass, Julie A.
AU - Friesen, Craig A.
AU - Deacy, Amanda D.
AU - Neilan, Nancy A.
AU - Bracken, Julia M.
AU - Shakhnovich, Valentina
AU - Singh, Vivekanand
N1 - Publisher Copyright:
© 2015 Bass et al.
PY - 2015/10/13
Y1 - 2015/10/13
N2 - 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-aα (TNF-aα) 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-aα 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.
AB - 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-aα (TNF-aα) 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-aα 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.
KW - Eosinophils
KW - Inflammatory bowel disease
KW - MMP-9
KW - TNF-aα
UR - http://www.scopus.com/inward/record.url?scp=84944037879&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84944037879&partnerID=8YFLogxK
U2 - 10.1186/s12876-015-0359-2
DO - 10.1186/s12876-015-0359-2
M3 - Article
C2 - 26463759
AN - SCOPUS:84944037879
SN - 1471-230X
VL - 15
JO - BMC Gastroenterology
JF - BMC Gastroenterology
IS - 1
M1 - 129
ER -