title: A study of calretinin in Hirschsprung pathology, particularly in total colonic aganglionosis.
abstract: BACKGROUND
  Calretinin, a calcium-binding protein, has been reported to be an important new marker in Hirschsprung's disease (HD). The aim is to study the diagnostic value of Calretinin in total colonic aganglionosis (TA), prematurity, and superficial biopsy when nerve hyperplasia may not be accessed by ACE activity.
  
  
  METHODS
  Records of patients diagnosed with HD at our institution from 1985 to 2010 were studied and patients with TA identified. We examined tissue samples from those TA, partial colectomies for HD, biopsies for suspicion of HD, and rectal tissue from aborted fetuses. Immunohistochemical analysis of Calretinin was compared with ACE gold standard method in all cases.
  
  
  RESULTS
  In the majority of the cases, the diagnosis was ascertained by ACE activity and Calretinin staining. However, in 9 cases, the diagnosis was possible with Calretinin staining but not with ACE: in 4 TA because of the absence of nerve hyperplasia, and in 5 cases because the biopsies were too superficial to examine the nerve hyperplasia. In addition, Calretinin was expressed in the gut as early as 22 gestational weeks.
  
  
  CONCLUSIONS
  The use of Calretinin staining may be superior to ACE activity, particularly in the context of TA, superficial biopsies, and prematurity, allowing earlier diagnosis.
authors.affiliation: Department of Pediatric Surgery, CHU Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada, H3C 1C5. melaniemorris.i@gmail.com
authors.forename: Melanie I
authors.initials: MI
authors.lastname: Morris
authors.forename: Dorothée Bouron-Dal
authors.initials: DB
authors.lastname: Soglio
authors.forename: Alain
authors.initials: A
authors.lastname: Ouimet
authors.forename: Ann
authors.initials: A
authors.lastname: Aspirot
authors.forename: Natalie
authors.initials: N
authors.lastname: Patey
mesh_terms: D000110:Acetylcholinesterase / Q000032:analysis; D001369:Axons / Q000737:chemistry; D015415:Biomarkers; D064032:Calbindin 2 / Q000032:analysis* / Q000096:biosynthesis; D002799:Cholinergic Fibers / Q000737:chemistry* / Q000473:pathology; D003106:Colon / Q000196:embryology / Q000294:innervation; D003979:Diazonium Compounds; D005629:Frozen Sections; D006627:Hirschsprung Disease / Q000175:diagnosis* / Q000196:embryology / Q000378:metabolism / Q000473:pathology; D006801:Humans; D006965:Hyperplasia; D007124:Immunoenzyme Techniques; D007413:Intestinal Mucosa / Q000737:chemistry; D009130:Muscle, Smooth / Q000737:chemistry; D009197:Myenteric Plexus / Q000737:chemistry; D009419:Nerve Tissue Proteins / Q000032:analysis* / Q000096:biosynthesis; D015588:Observer Variation; D011446:Prospective Studies; D012007:Rectum / Q000294:innervation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013194:Staining and Labeling / Q000379:methods; D013368:Submucous Plexus / Q000737:chemistry
chemical_list: D015415:Biomarkers; C576764:CALB2 protein, human; D064032:Calbindin 2; D003979:Diazonium Compounds; D009419:Nerve Tissue Proteins; D000110:Acetylcholinesterase