The pathophysiology of Hirschsprung's-associated enterocolitis: importance of histologic correlates.
To more clearly define the pathophysiology of Hirschsprung's-associated enterocolitis (HAEC), this study comprehensively evaluates the gastrointestinal tissue of a group of infants with clinical HAEC. A pathologic grading system that demonstrates a progressive sequence of histologic changes specific for HAEC is established. The grading system correlates closely with clinical enterocolitis and may prove to be a useful method for early detection of infants at risk for the development of clinical HAEC. A significant alteration of intestinal mucins with an increase in neutral mucins and a decrease in acidic-sulfomucins was identified in HAEC tissue specimens. Enterocyte-adherent organisms were present in 39% of HAEC tissue specimens. The pathogenesis of HAEC may result from an alteration in intestinal mucins that may allow for the subsequent adherence of enteropathogenic organisms to enterocytes. The enterocyte-adherent organisms have the potential to induce an enterocolitic process and may contribute to both the intestinal and systemic manifestations of HAEC.
Teitelbaum
D H
DH
Department of Surgery, Ohio State University College of Medicine, Columbus.
Caniano
D A
DA
Qualman
S J
SJ
D004760:Enterocolitis / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006627:Hirschsprung Disease / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009077:Mucins / Q000378:metabolism
D009077:Mucins