Anita Aujenath Chaudhari1, Sharada Raju Rane2, Meenal Vitthal Jadhav3. 1. Senior Resident, Department of Pathology, ESIC Model Hospital cum ODC, Andheri, Mumbai, Maharashtra, India. 2. Associate Professor, Department of Pathology, B J Govt Medical College, Pune, Maharashtra, India. 3. Professor and Head, Department of Pathology, R C S M Govt Medical College, Kolhapur, Kolhapur, Maharashtra, India.
Abstract
INTRODUCTION: Functional Dyspepsia (FD) is one of the most common causes of gastrointestinal symptoms aetiology of which is poorly understood. AIM: To study duodenal histomorphological features and their relationship with Helicobacter pylori (H Pylori) infection in patients of FD. MATERIALS AND METHODS: This case control study included 50 cases of FD patients selected according to Rome III criteria and 30 age and sex matched controls. These were subjected to oesophago-gastro-duodenoscopy, rapid urease test for detection of H. pylori on gastric antral biopsy and duodenal biopsy from second part of duodenum for histopathological evaluation by light microscopy. Ten antral urease positive cases of FD with highest Intraepithelial Lymphocyte Count (IEL) were subjected to Immunohistochemistry (IHC). RESULTS: Duodenal inflammation was an invariable feature noted in FD. Morphological spectrum consisted of increased IEL in 72%, increased duodenal eosinophils in 92%, presence of focal villous atrophy in 16%, lymphoid aggregates, colonic metaplasia, and duodenal H. pylori infection in 4% each. Gastric H. pylori positivity was noted in 48% cases of FD. Increased duodenal IEL count and duodenal eosinophilia was noted in 75%, 87.5% such cases. Same was noted respectively, with 61.5% and 95.15% cases with gastric H. pylori negativity. In cases of FD, duodenal IEL and eosinophil count in lamina propria showed statistically significant rise when compared with control and had positive correlation with gastric H pylori infection. On IHC, increased expression of CD 8 was noted in duodenal IEL and lymphocytes in lamina propria as compared to CD4. CONCLUSION: Our study provided some insight in pathogenesis of FD and role of H. pylori in its aetiology.
INTRODUCTION:Functional Dyspepsia (FD) is one of the most common causes of gastrointestinal symptoms aetiology of which is poorly understood. AIM: To study duodenal histomorphological features and their relationship with Helicobacter pylori (H Pylori) infection in patients of FD. MATERIALS AND METHODS: This case control study included 50 cases of FDpatients selected according to Rome III criteria and 30 age and sex matched controls. These were subjected to oesophago-gastro-duodenoscopy, rapid urease test for detection of H. pylori on gastric antral biopsy and duodenal biopsy from second part of duodenum for histopathological evaluation by light microscopy. Ten antral urease positive cases of FD with highest Intraepithelial Lymphocyte Count (IEL) were subjected to Immunohistochemistry (IHC). RESULTS: Duodenal inflammation was an invariable feature noted in FD. Morphological spectrum consisted of increased IEL in 72%, increased duodenal eosinophils in 92%, presence of focal villous atrophy in 16%, lymphoid aggregates, colonic metaplasia, and duodenal H. pyloriinfection in 4% each. Gastric H. pylori positivity was noted in 48% cases of FD. Increased duodenal IEL count and duodenal eosinophilia was noted in 75%, 87.5% such cases. Same was noted respectively, with 61.5% and 95.15% cases with gastric H. pylori negativity. In cases of FD, duodenal IEL and eosinophil count in lamina propria showed statistically significant rise when compared with control and had positive correlation with gastric H pylori infection. On IHC, increased expression of CD 8 was noted in duodenal IEL and lymphocytes in lamina propria as compared to CD4. CONCLUSION: Our study provided some insight in pathogenesis of FD and role of H. pylori in its aetiology.
Authors: X Fan; S E Crowe; S Behar; H Gunasena; G Ye; H Haeberle; N Van Houten; W K Gourley; P B Ernst; V E Reyes Journal: J Exp Med Date: 1998-05-18 Impact factor: 14.307
Authors: Magnus Halland; Nicholas J Talley; Mike Jones; Joseph A Murray; Raquel Cameron; Marjorie M Walker Journal: Dig Dis Sci Date: 2018-11-26 Impact factor: 3.199