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Abnormal vasculature in intestinal neuronal dysplasia

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Abstract

Intestinal neuronal dysplasia (IND) is an intestinal motility disorder, which clinically resembles Hirschsprung's disease (HD). Adventitial fibromuscular dysplasia (AFMD) consists of proliferation of smooth muscle cells and collagen fibers in the adventitia of blood vessels. The purpose of this study was to investigate vascular abnormalities in large bowel biopsies from patients with isolated HD, IND associated with HD and isolated IND. Large bowel biopsies from patients presenting with isolated HD ( n =23), IND associated with HD ( n =11), isolated IND ( n =16) and normal bowel as controls ( n =6) were investigated using acetylcholinesterase (AChE) histochemistry, van Gieson staining and α-smooth muscle actin (α-SMA) immunohistochemistry. Increased AChE activity around submucosal vessels was found in 9/16 (56%) cases with isolated IND, 3/11 (27%) cases of IND associated with HD, 5/23 (21%) isolated HD cases and 0/6 controls. AFMD was found in 10/16 (62%) of the isolated IND cases, 4/11 (362) of the cases with IND associated with HD and 4/23 (17%) cases of HD without IND using van Gieson staining. None of the control specimens revealed AFMD. Increased α-SMA immunoreactivity filaments were demonstrated in the submucosal vessel wall in 9/16 (56%) of isolated IND and 2/11(18%) of IND associated with HD cases. Normal α-SMA immunoreactivity around submucosal vessels was seen in isolated HD and controls. Abnormal submucosal vasculature is a common histological finding in isolated IND and IND associated with HD and may be a useful additional diagnostic feature in these patients.

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  1. Children's Research Centre, Our Lady's Hospital for Sick Children, University College, Dublin , Ireland

    Udo Rolle, Anna Piaseczna Piotrowska & Prem Puri

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  1. Udo Rolle
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  2. Anna Piaseczna Piotrowska
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  3. Prem Puri
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Correspondence to Prem Puri.

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Rolle, U., Piotrowska, A.P. & Puri, P. Abnormal vasculature in intestinal neuronal dysplasia. Ped Surgery Int 19, 345–348 (2003). https://doi.org/10.1007/s00383-003-1008-3

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