Evaluation of tissue eosinophilia in the pouch and afferent limb in patients with restorative proctocolectomy

Shen, Bo; Plesec, Thomas; Remzi, Feza H.; Kariv, Revital; López, Rocío; Queener, Elaine; Fazio, Victor W.; Goldblum, John R.

doi:10.1002/ibd.20401

Cited by 9 publications

(7 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Schmidt et al [9] showed that terminal ileal eosinophils are significant predictors of active inflammation in subsequent IPAA pouch biopsy specimens, but lymphocyte aggregates and intraepithelial lymphocytes are not. Moreover, tissue eosinophilia in the pouch is reportedly more Dig Surg 2018;35:138-143 DOI: 10.1159/000477268 142 prominent than that in the afferent limb in patients who have undergone IPAA [37]. Although pouchitis seems to be associated with eosinophil-mediated inflammation based on the results of these studies, fewer eosinophils in the colon than in the ileum has a significant impact on the development of pouchitis and chronic pouchitis.…”

Section: Discussionmentioning

confidence: 56%

Colonic Histological Criteria Predict Development of Pouchitis after Ileal Pouch: Anal Anastomosis for Patients with Ulcerative Colitis

Araki

Hashimoto²,

Okita³

et al. 2017

Dig Surg

View full text Add to dashboard Cite

Background/Aims: Pouchitis is one of the main complications after ileal pouch-anal anastomosis in patients with ulcerative colitis. The aim of this study was to determine whether the use of colonic histological criteria can predict the development of pouchitis. Methodology: We retrospectively reviewed 147 patients' clinical data and performed a histological evaluation of the resected total colon using Tanaka's criteria, which comprise the following 6 factors: ulceration (H₁), crypt abscesses (H₂), degree of mononuclear cell infiltration (MNCI) (H₃), segmental distribution of MNCI (H₄), eosinophil infiltration (H₅), and extent of disease of resected colon (H₆). Results: The development of pouchitis and chronic pouchitis within 3 years after restoration of gastrointestinal continuity was recognized in 52 (35.4%) and 26 (17.7%) of the 147 patients, respectively. Using various combinations of each score, the H₃ + H₄ - H₅ scores of patients with pouchitis or chronic pouchitis were significantly higher than those of patients without. A H₃ + H₄ - H₅ score of >0.4 was a statistically significant risk factor for the development of both pouchitis and chronic pouchitis. Conclusions: The combination of the degree of MNCI, segmental distribution of MNCI, and eosinophil infiltration from histological criteria has utility in predicting the future development of pouchitis, especially chronic pouchitis.

show abstract

Section: Discussionmentioning

confidence: 56%

Colonic Histological Criteria Predict Development of Pouchitis after Ileal Pouch: Anal Anastomosis for Patients with Ulcerative Colitis

Araki

Hashimoto²,

Okita³

et al. 2017

Dig Surg

View full text Add to dashboard Cite

show abstract

“…Biopsies from the pouch often show a variable increase in the number of intramucosal eosinophils. 6 Prominent eosinophils were observed in 44% of the involved biopsies 4 . Thus, a low threshold for utilizing CD117 stain to confirm the presence of subtle mast cell aggregates can be very helpful.…”

Section: Discussionmentioning

confidence: 99%

Ileal Pouch Biopsy Triggers Investigation and Diagnosis of Systemic Mastocytosis

Mannan

Shen

Hsieh

et al. 2016

ACG Case Reports Journal

Self Cite

View full text Add to dashboard Cite

We report a unique case of systemic mastocytosis (SM) diagnosed in an ileal pouch biopsy obtained from a 44-year-old woman with ulcerative colitis. She presented with intermittent abdominal pain and watery diarrhea that did not respond to antibiotic therapy. The pouch biopsy showed expansion of the lamina propria by aggregates of CD117 and CD25-positive abnormal mast cells. A subsequent bone marrow analysis showed an increase in abnormal mast cells. Based on World Health Organization criteria, she was diagnosed with SM and responded to cromolyn sodium therapy. Systemic mastocytosis can mimic pouchitis, and thus recognition of this condition is important for appropriate clinical management.

show abstract

“…More recent studies, however, have reported a possible dual role for the eosinophil with noted involvement in tissue destruction and repair in the different stages of UC as eosinophils were actually higher in inactive UC than in the active phase of the disease [ 28 , 29 ]. Shen et al found that tissue eosinophilia in ileal pouch mucosa in IBD patients treated with restorative proctocolectomy was found to be more prominent than that in the afferent limb, suggesting that luminal factors in different areas of the bowel may contribute to eosinophil-mediated inflammation [ 30 ]. Our finding of eosinophilia in the rectosigmoid area of the patients later diagnosed with IBD in comparison to abdominal pain patients suggests that eosinophilia may be an early indicator of disease progression.…”

Section: Discussionmentioning

confidence: 99%

Investigation of potential early Histologic markers of pediatric inflammatory bowel disease

et al. 2015

View full text Add to dashboard Cite

BackgroundEarly 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.MethodsA 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-α (TNF-α) and matrix metalloproteinase-9 (MMP-9) was performed on the stomach and rectosigmoid areas.ResultsGastritis 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-α and MMP-9 staining did not reveal any significant differences.ConclusionsOur 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.

show abstract

Evaluation of tissue eosinophilia in the pouch and afferent limb in patients with restorative proctocolectomy

Cited by 9 publications

References 30 publications

Colonic Histological Criteria Predict Development of Pouchitis after Ileal Pouch: Anal Anastomosis for Patients with Ulcerative Colitis

Colonic Histological Criteria Predict Development of Pouchitis after Ileal Pouch: Anal Anastomosis for Patients with Ulcerative Colitis

Ileal Pouch Biopsy Triggers Investigation and Diagnosis of Systemic Mastocytosis

Investigation of potential early Histologic markers of pediatric inflammatory bowel disease

Contact Info

Product

Resources

About