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ABSTRACT: Counting immunoglobulin (Ig)-containing cells in colonic mucosal biopsies can help to objectively support the differential diagnosis of ulcerative colitis and Crohn's disease. Before a method for counting Ig-containing cells can be applied in a clinical setting, however, its reproducibility must be determined. This study investigated the reproducibility of two different methods for counting such cells. The use of a light microscope with an ocular grid resulted in a slightly better reproducibility than did the use of a projection microscope with a graphics tablet. Moreover, the ocular grid method had a higher efficiency. The counting of IgM- and IgG-containing cells had a considerably higher reproducibility than did the counting of IgA-containing cells. To determine the minimal number of cells to be counted in order to ascertain a stabilized mean number of Ig-containing cells, the running means of counts of Ig-containing cells were calculated for two observers. When at least 600 Ig-containing cells (i.e., two to four fields) were counted, the interobserver variation of the running means was less than 10% for IgA and IgG counts and less than 5% for IgM counts. Since earlier studies showed differences in the counts of IgA-, IgG- and IgM-containing cells between ulcerative colitis and Crohn's disease to be, respectively, 3%, 25% and 28%, the results of the present study suggest that the proposed counting method can be useful in the differentiation between these entities.
Analytical and quantitative cytology and histology / the International Academy of Cytology [and] American Society of Cytology 05/1988; 10(2):94-100. · 0.41 Impact Factor
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ABSTRACT: To determine the prevalence of Campylobacter fetus subspecies jejuni-associated appendicitis, we studied, retrospectively, by means of immunohistochemistry, the appendectomy specimens of 116 consecutive patients, operated upon because of suspected acute appendicitis. We found immunohistochemical evidence of Campylobacter fetus subspecies jejuni infection in three patients. These findings were confirmed by electron microscopy. Based upon these three cases and five additional appendectomy specimens from patients with Campylobacter enteritis diagnosed by stool cultures, the clinical and histologic picture of Campylobacter-associated appendicitis is described. It is concluded that Campylobacter infection may present with an acute appendicitis-like clinical picture. In contrast with acute phlegmonous appendicitis, the histologic abnormalities in Campylobacter-associated appendicitis are limited to the appendiceal mucosa.
Pathology annual 02/1987; 22 Pt 1:55-65.
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ABSTRACT: The morphometric quantitative analysis of immunoglobulin-containing cells in gastrointestinal biopsies was explored as a possible additional parameter in making the histologic diagnosis of gastrointestinal diseases. Determination of immunoglobulin-containing cells was useful in the differential diagnosis of small intestinal disorders and may be useful in inflammatory diseases of the colon. However, before its general application in diagnosing inflammatory diseases of the colon can be advocated, prospective studies are necessary to determine the specificity and sensitivity of the quantitative analysis of immunoglobulin-containing cells in individual cases of large bowel disease.
Analytical and quantitative cytology and histology / the International Academy of Cytology [and] American Society of Cytology 01/1987; 8(4):314-20. · 0.41 Impact Factor
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Pathology annual 02/1986; 21 Pt 1:295-310.
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ABSTRACT: The colonic biopsy specimens of 22 patients with colitis and positive stool cultures for Campylobacter jejuni were studied in order to obtain histological and immunohistochemical criteria to differentiate Campylobacter colitis from chronic inflammatory bowel disease. In addition we tried to identify Campylobacter inclusions by means of immunohistochemistry and electron microscopy as evidence for invasion of the colonic mucosa. The results show that the majority of patients with Campylobacter colitis have the histological picture of acute infectious colitis with increased numbers of IgA and IgM containing plasma cells in the colonic mucosa in contrast with patients with active chronic inflammatory bowel disease who show increases of IgA and IgG (ulcerative colitis) or IgA-, IgM and IgG containing plasma cells (M Crohn) in their colonic biopsies. The results of immunohistochemical stainings with Campylobacter antiserum show invasion of Campylobacter in the colonic mucosa. These findings were confirmed ultrastructurally.
Gut 10/1985; 26(9):945-51. · 10.11 Impact Factor
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ABSTRACT: In colonic biopsies of 33 patients with acute colitis caused by campylobacter, salmonella, or shigella immunoglobulin containing cells were determined quantitatively using an indirect immunoperoxidase technique and morphometry with a graphic tablet. The findings were compared with those of 10 patients without histological abnormalities, 10 patients with Crohn's disease of the colon, and 10 patients with ulcerative colitis. Biopsies of patients with acute infectious colitis had increased numbers of IgA containing cells and to a lesser extent IgM containing cells but not IgG containing cells compared with controls. Compared with the patients with active chronic idiopathic inflammatory bowel disease the patients with acute colitis showed significantly lower relative and absolute numbers of IgG containing cells. We therefore conclude that quantitative assessment of immunoglobulin containing cells in colonic biopsies may be useful in the differential diagnosis of acute infectious colitis and chronic idiopathic inflammatory bowel disease.
Journal of Clinical Pathology 08/1985; 38(7):774-7. · 2.31 Impact Factor
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Nederlands tijdschrift voor geneeskunde 06/1985; 129(19):899-903.
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ABSTRACT: The numbers of IgA, IgM and IgG-containing cells were studied by means of an indirect immunoperoxidase technique and morphometry in liver biopsies of patients with primary biliary cirrhosis and chronic hepatitis, in whom serum immunoglobulin concentrations were also determined. In patients with primary biliary cirrhosis the absolute and relative number of IgM-containing cells in the liver was significantly higher, whereas the absolute and relative number of IgG-containing cells in the liver was significantly lower compared to patients with chronic hepatitis. IgM-containing cells in liver biopsies of patients with primary biliary cirrhosis correlated strongly with their serum IgM levels. It is concluded that determination of the pattern of immunoglobulin containing cells in liver biopsies may help in the differentiation of primary biliary cirrhosis from chronic hepatitis and that local production of IgM in the liver may contribute significantly to the high serum IgM levels in patients with primary biliary cirrhosis.
Histopathology 08/1984; 8(4):559-66. · 3.08 Impact Factor
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ABSTRACT: Gastric and duodenal biopsies from 2543 patients with abdominal complaints were sent to the Department of Pathology of the Stichting Samenwerking Delftse Ziekenhuizen in 1980 and 1981 and screened for plasma cells containing IgE using an indirect immunoperoxidase technique. Increased numbers of IgE containing cells were found in 2.6% of the patients. These patients all suffered from a variety of chronic non-specific inflammatory disorders of the upper gastrointestinal tract. No specific clinical, endoscopical, or histological picture could be found. The results suggest that increased numbers of plasma cells containing IgE in biopsies from the upper gastrointestinal tract are an expression of IgE mediated type I allergy presumably to food constituents as a secondary complication of chronic non-specific gastric and duodenal inflammation in these patients.
Journal of Clinical Pathology 07/1984; 37(6):601-6. · 2.31 Impact Factor
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The Netherlands Journal of Medicine 02/1983; 26(9):287-8. · 2.07 Impact Factor
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ABSTRACT: The histological findings and the number of immunoglobulin-containing cells in gastric and duodenal biopsies from patients with Crohn's disease of the large or small bowel, or both, with and without upper gastrointestinal complaints, are reported and compared with those of healthy controls and patients with chronic non-specific gastritis and duodenitis. The gastric and duodenal biopsies from patients with Crohn's disease showed a higher incidence of chronic non-specific inflammation and a significant increase of IgM-containing cells compared with healthy controls. The increase of IgM-containing cells in the lamina propria cannot be explained by the high incidence of chronic non-specific inflammation, a condition shown to have increased numbers of IgM-containing cells as well, since patients with Crohn's disease of the ileum or colon, or both, without histological abnormalities of the gastric and duodenal mucosa also showed an increase of IgM-containing cells. It is concluded that both the high incidence of chronic non-specific inflammation in gastric and duodenal biopsies and the increased number of IgM-containing cells are an expression of Crohn's disease as a systemic disorder of the gastrointestinal tract.
Journal of Clinical Pathology 10/1982; 35(9):934-40. · 2.31 Impact Factor
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ABSTRACT: Intramural hematoma of the duodenum is usually caused by blunt abdominal injury. Sometimes this lesion occurs in patients with coagulation disturbances or pancreatic disease such as chronic pancreatitis. There also appears to be a link with alcohol abuse. We describe the case-history of a 45-year-old male with chronic pancreatitis who presented with abdominal pain. The diagnosis of a space-occupying process of the duodenum was made and subsequently a pancreatico-duodenectomy was performed. The duodenum revealed an intramural hematoma, the pancreas showed signs of mild chronic pancreatitis.
Endoscopy 12/1981; 13(6):246-8. · 5.21 Impact Factor
