Investigation of potential early Histologic markers of pediatric inflammatory bowel disease

Julie A. Bass, Craig A. Friesen, Amanda D. Deacy, Nancy A. Neilan, Julia M. Bracken, Valentina Shakhnovich, Vivekanand Singh

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Article number129
JournalBMC Gastroenterology
Volume15
Issue number1
DOIs
StatePublished - Oct 13 2015
Externally publishedYes

Fingerprint

Inflammatory Bowel Diseases
Pediatrics
Stomach
Matrix Metalloproteinase 9
Biopsy
Eosinophils
Tumor Necrosis Factor-alpha
Staining and Labeling
Eosinophilia
Gastritis
Duodenum
Abdominal Pain
Endoscopy
Colon
Immunohistochemistry
Inflammation

Keywords

  • Eosinophils
  • Inflammatory bowel disease
  • MMP-9
  • TNF-aα

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Bass, J. A., Friesen, C. A., Deacy, A. D., Neilan, N. A., Bracken, J. M., Shakhnovich, V., & Singh, V. (2015). Investigation of potential early Histologic markers of pediatric inflammatory bowel disease. BMC Gastroenterology, 15(1), [129]. https://doi.org/10.1186/s12876-015-0359-2

Investigation of potential early Histologic markers of pediatric inflammatory bowel disease. / Bass, Julie A.; Friesen, Craig A.; Deacy, Amanda D.; Neilan, Nancy A.; Bracken, Julia M.; Shakhnovich, Valentina; Singh, Vivekanand.

In: BMC Gastroenterology, Vol. 15, No. 1, 129, 13.10.2015.

Research output: Contribution to journalArticle

Bass JA, Friesen CA, Deacy AD, Neilan NA, Bracken JM, Shakhnovich V et al. Investigation of potential early Histologic markers of pediatric inflammatory bowel disease. BMC Gastroenterology. 2015 Oct 13;15(1). 129. https://doi.org/10.1186/s12876-015-0359-2
Bass, Julie A. ; Friesen, Craig A. ; Deacy, Amanda D. ; Neilan, Nancy A. ; Bracken, Julia M. ; Shakhnovich, Valentina ; Singh, Vivekanand. / Investigation of potential early Histologic markers of pediatric inflammatory bowel disease. In: BMC Gastroenterology. 2015 ; Vol. 15, No. 1.
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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.

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