Is mastocytic colitis a specific clinical-pathological entity?
The number of intestinal mast cells (MC) is increased in several types of colitis, but the mucosa of patients with chronic non-bloody diarrhea has not been studied. The current study sought to determine the relationship between MC counts and degranulation and the severity of symptoms in patients wi...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
PAGEPress Publications
2022-11-01
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| Series: | European Journal of Histochemistry |
| Subjects: | |
| Online Access: | https://www.ejh.it/index.php/ejh/article/view/3499 |
| _version_ | 1811323056385163264 |
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| author | Filippo Vernia Tiziana Tatti Stefano Necozione Annalisa Capannolo Nicola Cesaro Marco Magistroni Marco Valvano Simona Pompili Roberta Sferra Antonella Vetuschi Giovanni Latella |
| author_facet | Filippo Vernia Tiziana Tatti Stefano Necozione Annalisa Capannolo Nicola Cesaro Marco Magistroni Marco Valvano Simona Pompili Roberta Sferra Antonella Vetuschi Giovanni Latella |
| author_sort | Filippo Vernia |
| collection | DOAJ |
| description |
The number of intestinal mast cells (MC) is increased in several types of colitis, but the mucosa of patients with chronic non-bloody diarrhea has not been studied. The current study sought to determine the relationship between MC counts and degranulation and the severity of symptoms in patients with chronic loose stools. Following a negative laboratory workup for the most common causes of chronic diarrhea, patients with chronic non-bloody loose stools were included in the study. Patients with macroscopic evidence of inflammation or organic disease were excluded after endoscopy with biopsies. Biopsies from the 179 patients in the study were stained with hematoxylin and eosin and anti-CD117 c-kit antibodies. Immunohistochemistry was used to assess the degree of MC degranulation. Out of the 179 patients, 128 had normal histologic findings suggestive of irritable bowel syndrome and were used as controls. Twenty-four presented with abnormally high MC counts (≥40 MC x HPF), 23 with ≥20 intraepithelial lymphocytes x HPF suggesting lymphocytic colitis, and 4 had both (≥40 MC and ≥20 intraepithelial lymphocytes x HPF). In the patients with high MC counts, figures were significantly higher in the right colon versus the left colon (p=0.016), but degranulation did not differ in the right versus the left colon (p=0.125). No age or sex-related difference was observed (p=0.527 and p=0.859 respectively). The prevalence of abdominal pain and bloating did not differ in the three groups (p=0.959 and p=0.140, respectively). Patients with lymphocytic colitis (p=0.008) and those with high MC counts (p=0.025) had significantly higher evacuation rates compared to controls. There was no difference between these two groups (p=0.831). Mast cell degranulation was not associated with the number of evacuations, abdominal pain, or bloating (p=0.51; p=0.41; p=0.42, respectively). The finding that a significantly higher number of evacuations was linked to increased MC in the colonic mucosa of a subset of patients with otherwise normal laboratory and endoscopic findings suggests that "mastocytic colitis" may be a new clinical-pathological entity responsible for chronic non-bloody diarrhea. Prospective studies with a larger number of patients, as well as endoscopic and histological follow-up, are needed to confirm this hypothesis.
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| first_indexed | 2024-04-13T13:47:09Z |
| format | Article |
| id | doaj.art-cbcca931721742b8a7a9f3deb38d0383 |
| institution | Directory Open Access Journal |
| issn | 1121-760X 2038-8306 |
| language | English |
| last_indexed | 2024-04-13T13:47:09Z |
| publishDate | 2022-11-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | European Journal of Histochemistry |
| spelling | doaj.art-cbcca931721742b8a7a9f3deb38d03832022-12-22T02:44:26ZengPAGEPress PublicationsEuropean Journal of Histochemistry1121-760X2038-83062022-11-0166410.4081/ejh.2022.3499Is mastocytic colitis a specific clinical-pathological entity?Filippo Vernia0Tiziana Tatti1Stefano Necozione2Annalisa Capannolo3Nicola Cesaro4Marco Magistroni5Marco Valvano6Simona Pompili7Roberta Sferra8Antonella Vetuschi9Giovanni Latella10Gastroenterology Unit, Department of Life, Health and Environmental Sciences, University of L’AquilaPathology Unit, S. Salvatore Academic Hospital, L'AquilaEpidemiology Unit, Department of Life, Health and Environmental Sciences, University of L'AquilaDiagnostic and Surgical Endoscopy Unit, San Salvatore Academic Hospital, L'AquilaGastroenterology Unit, Department of Life, Health and Environmental Sciences, University of L’AquilaGastroenterology Unit, Department of Life, Health and Environmental Sciences, University of L’AquilaGastroenterology Unit, Department of Life, Health and Environmental Sciences, University of L’AquilaDepartment of Biotechnological and Applied Clinical Sciences, University of L'AquilaDepartment of Biotechnological and Applied Clinical Sciences, University of L'AquilaDepartment of Biotechnological and Applied Clinical Sciences, University of L'AquilaGastroenterology Unit, Department of Life, Health and Environmental Sciences, University of L’Aquila The number of intestinal mast cells (MC) is increased in several types of colitis, but the mucosa of patients with chronic non-bloody diarrhea has not been studied. The current study sought to determine the relationship between MC counts and degranulation and the severity of symptoms in patients with chronic loose stools. Following a negative laboratory workup for the most common causes of chronic diarrhea, patients with chronic non-bloody loose stools were included in the study. Patients with macroscopic evidence of inflammation or organic disease were excluded after endoscopy with biopsies. Biopsies from the 179 patients in the study were stained with hematoxylin and eosin and anti-CD117 c-kit antibodies. Immunohistochemistry was used to assess the degree of MC degranulation. Out of the 179 patients, 128 had normal histologic findings suggestive of irritable bowel syndrome and were used as controls. Twenty-four presented with abnormally high MC counts (≥40 MC x HPF), 23 with ≥20 intraepithelial lymphocytes x HPF suggesting lymphocytic colitis, and 4 had both (≥40 MC and ≥20 intraepithelial lymphocytes x HPF). In the patients with high MC counts, figures were significantly higher in the right colon versus the left colon (p=0.016), but degranulation did not differ in the right versus the left colon (p=0.125). No age or sex-related difference was observed (p=0.527 and p=0.859 respectively). The prevalence of abdominal pain and bloating did not differ in the three groups (p=0.959 and p=0.140, respectively). Patients with lymphocytic colitis (p=0.008) and those with high MC counts (p=0.025) had significantly higher evacuation rates compared to controls. There was no difference between these two groups (p=0.831). Mast cell degranulation was not associated with the number of evacuations, abdominal pain, or bloating (p=0.51; p=0.41; p=0.42, respectively). The finding that a significantly higher number of evacuations was linked to increased MC in the colonic mucosa of a subset of patients with otherwise normal laboratory and endoscopic findings suggests that "mastocytic colitis" may be a new clinical-pathological entity responsible for chronic non-bloody diarrhea. Prospective studies with a larger number of patients, as well as endoscopic and histological follow-up, are needed to confirm this hypothesis. https://www.ejh.it/index.php/ejh/article/view/3499microscopic colitismast cellmastocytic colitislymphocytic colitischronic diarrhea |
| spellingShingle | Filippo Vernia Tiziana Tatti Stefano Necozione Annalisa Capannolo Nicola Cesaro Marco Magistroni Marco Valvano Simona Pompili Roberta Sferra Antonella Vetuschi Giovanni Latella Is mastocytic colitis a specific clinical-pathological entity? European Journal of Histochemistry microscopic colitis mast cell mastocytic colitis lymphocytic colitis chronic diarrhea |
| title | Is mastocytic colitis a specific clinical-pathological entity? |
| title_full | Is mastocytic colitis a specific clinical-pathological entity? |
| title_fullStr | Is mastocytic colitis a specific clinical-pathological entity? |
| title_full_unstemmed | Is mastocytic colitis a specific clinical-pathological entity? |
| title_short | Is mastocytic colitis a specific clinical-pathological entity? |
| title_sort | is mastocytic colitis a specific clinical pathological entity |
| topic | microscopic colitis mast cell mastocytic colitis lymphocytic colitis chronic diarrhea |
| url | https://www.ejh.it/index.php/ejh/article/view/3499 |
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