Giardiasis: a histologic analysis of 567 cases.
BACKGROUND
The histopathology of the upper and lower gastrointestinal tract of patients with giardiasis as shown by endoscopy with biopsy is ill-defined. We therefore report on 567 cases observed in our institution.


METHODS
A retrospective analysis of all cases with giardiasis observed between 1988 and 1994 was performed.


RESULTS
On histologic slides trophozoites were found in duodenal (82.5%) and jejunal (2.1%) mucosa and also in gastric antral (8.7%) and ileal mucosa (12.1%) but rarely in the colon (0.4%). An entirely normal light-microscopic appearance of the duodenal mucosa was found in 462 cases (96.3%). Mild villous shortening and mild inflammation of the lamina propria were observed in duodenal mucosa in 18 subjects (3.7%). In jejunal, ileal, gastric, and colonic mucosa, no Giardia-specific histologic changes were identified. There was a clear male predominance with 347 (61.2%) males and 220 (38.8%) females. Mean age, which was comparable in males and females, was 49.5 +/- 17 years (range, 3-95 years). In 252 Giardia-positive cases gastric biopsy specimens were available, and showed Helicobacter pylori-associated gastritis in 57.8%, reactive gastritis in 10.3%, normal mucosa in 12.9%, chronic atrophic gastritis of the body in 2.9%, and other forms of gastritis in 16.1%.


CONCLUSIONS
This study shows that the histology of the small-bowel mucosa is inconspicuous in most subjects with giardiasis. A search for the parasite must therefore be made in all biopsy samples obtained from this area. Furthermore, giardiasis was not associated with a particular gastric disease, such as chronic atrophic gastritis of the body.
Oberhuber
G
G
Dept. of Clinical Pathology, AKH, University of Vienna, Medical School, Austria.
Kastner
N
N
Stolte
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004064:Digestive System / Q000469:parasitology / Q000473:pathology; D005260:Female; D005756:Gastritis / Q000150:complications / Q000473:pathology; D005873:Giardiasis / Q000150:complications / Q000473:pathology*; D016481:Helicobacter Infections / Q000150:complications / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D007413:Intestinal Mucosa / Q000469:parasitology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors