Evaluation of Mucosal Eosinophils in the Pediatric Colon
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To evaluate the clinical significance of colonic eosinophilia, we conducted a retrospective study of all children older than 1 year evaluated at Children’s Hospital of Pittsburgh from January 1999 to June 2001 with a description of colonic eosinophilia in the pathology report. Medical records were reviewed. Diagnoses were confirmed by contacting the patients. Histological slides (H&E) were reviewed by an investigator blind to the patients’ data. Biopsies were grouped according to the site they were taken from and then screened at low power for areas of maximal eosinophilia for further quantitative analysis. Results of manual counts were validated by image analysis using Metaphor Image Analysis Software. Sixty-nine children with colonic eosinophilia were identified (36 male; mean age, 135.2 ± 55.4 months). Their final diagnoses were inflammatory bowel disease in 32% (group A), irritable bowel syndrome in 33% (group B), food allergies in 10% (group C), and other diagnoses in 25% (group D). The maximal eosinophil count per crypt area was significantly (P < 0.05) higher in group A vs groups B, C, and D (34.8 ± 17.1 vs 21.3 ± 8.8, 25.4 ± 16.7, and 24.2 ± 9.7, respectively). The total cellularity of the lamina propria was considered high only in group A (P < 0.05 vs groups B and C). A mostly equal vertical distribution of eosinophils throughout the lamina propria was found significantly more frequently in group A vs groups C (P = 0.04) and D (P = 0.007). We conclude that children with inflammatory bowel disease have an equal distribution of eosinophils throughout the lamina propria, with intraepithelial and intracryptal eosinophils and with a higher overall total cellularity. In irritable bowel syndrome and patients with a variety of other diagnoses, including allergies, the distribution is mostly superficial, with a lower total cellularity.
KEY WORDSeosinophils colon functional bowel disorders
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- Goldman H, Proujansky R: Allergic proctitis and gastroenteritis in children. Clinical and mucosal biopsy features in 53 cases. Am J Surg Pathol 10:75–86, 1986Google Scholar
- Heatley RV, James PD: Eosinophils in the rectal mucosa. A simple method of predicting the outcome of ulcerative proctocolitis? Gut 20:787–791, 1979Google Scholar
- Johnstone JM, Morson BC: Eosinophilic gastroenteritis. Histo- pathology 2:335–348, 1978Google Scholar
- Goldman H: Gastrointestinal Biopsy. New York, Churchill Livingstone, 1996, p 241Google Scholar
- O’Sullivan M: Increased mast cells in the irritable bowel syndrome. Neurogastroenterol Mot 12:449–457, 2000Google Scholar
- Furuta GTAS, Wershil BK: The role of the eosinophil in gastrointestinal diseases. Curr Opin Gastroenterol 11:541–547, 1995Google Scholar
- Sarin SK, Malhotra V, Sen Gupta S, Karol A, Gaur SK, Anand BS: Significance of eosinophil and mast cell counts in rectal mucosa in ulcerative colitis. A prospective controlled study. Dig Dis Sci 32:363–367, 1987Google Scholar
- Bischoff S: Mucosal allergy: Role of mast cells and eosinophil granulocytes in the gut. Bailliere’s Clin Gastroenterol 10:443–459, 1996Google Scholar