| Lymphocytic Follicles and Aggregates Are a Determinant of Mucosal Damage and Duration of Diarrhea. | |
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MedLine Citation:
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PMID: 23276179 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Context.-Nonspecific changes (nonspecific chronic inflammation) in patients with chronic diarrhea represent the commonest diagnosis in colorectal biopsy interpretation, but these changes are of little clinical significance. Objective.-To find, within this group, histologic and immunohistologic diagnostic criteria to predict the duration and resolution of diarrhea. Design.-Detailed clinical features and histologic findings were analyzed in a cohort of 47 patients with chronic diarrhea, with near-normal histology and no clear-cut known etiologic agent. Immunohistochemistry to mast cells (CD117) and Treg cells (FOXP3) was also assessed in 39 patients. Results.-Increased number of lymphoid follicles and aggregates, increased number of mast cells, and paucity of Treg were the statistically significant key findings (P = .003, P = .008, and P = .04, respectively). The duration of diarrhea was correlated with the number of large lymphoid follicles and aggregates (P = .001, r = .48), number of total lymphoid follicles and aggregates (P = .003, r = .43), density of lymphoid follicles and aggregates (P = .009, r = .38), and total lymphoid follicles and aggregates per biopsy (P = .004, r = .42) and the number of mast cells (P = .001, r = .52). The number of mast cells and Treg cells showed significant difference between resolved and unresolved cases (P = .001 and P = .01 respectively). Conclusions.-Lymphocytic follicles and aggregates colitis, previously regarded as of negligible diagnostic significance, allows the prediction of the behavior of chronic diarrhea in a subset of patients with nonspecific changes on colonic biopsy. The increased number of mast cells and paucity of Treg cells further helps to identify such unresolved cases. |
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Authors:
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Nilesh Shah; Bhavin Thakkar; Emily Shen; Marie Loh; Pei Yi Chong; Wee Hoe Gan; Tian Ming Tu; Liang Shen; Richie Soong; Manuel Salto-Tellez |
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Publication Detail:
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Type: JOURNAL ARTICLE |
Journal Detail:
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Title: Archives of pathology & laboratory medicine Volume: 137 ISSN: 1543-2165 ISO Abbreviation: Arch. Pathol. Lab. Med. Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-1 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7607091 Medline TA: Arch Pathol Lab Med Country: - |
Other Details:
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Languages: ENG Pagination: 83-89 Citation Subset: - |
Affiliation:
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From the Cancer Science Institute of Singapore (Drs Shah, Thakkar, Soong, and Salto-Tellez, Ms Loh, and Ms Chong), the Department of Pathology, National University Hospital, Yong Loo Lin Medical School (Drs Soong and Salto-Tellez), and the Biostatistics Unit, Yong Loo Lin Medical School (Dr L. Shen), National University of Singapore, Singapore; the Endoscopy Centre (Gastroenterology), Tan Tock Seng Hospital, Singapore (Dr E. Shen, Dr Gan, and Dr Tu); and the Centre for Cancer Research and Cell Biology, Queen's University, Belfast, United Kingdom (Dr Salto-Tellez). |
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