title: Focal enhanced gastritis and macrophage microaggregates in the gastric mucosa: potential role in the differential diagnosis between Crohn's disease and ulcerative colitis.
abstract: OBJECTIVE
  Focally enhanced gastritis and macrophage microaggregates are found in the upper gastrointestinal involvement of Crohn's disease, and may reflect an underlying defective innate immunity. These features, however, are also described in patients with Helicobacter pylori infection. The role of these gastric abnormalities in the diagnosis of Crohn's disease was assessed in a population with high prevalence of H. pylori infection.
  
  
  METHODS
  Thirty-seven Crohn's disease, 26 ulcerative colitis, and 30 control patients were included. The H. pylori status was evaluated by the rapid urease test and histology. The presence of focally enhanced gastritis and macrophage microaggregates was recorded.
  
  
  RESULTS
  Focally enhanced gastritis was present in 24% of Crohn's disease patients, 4% of ulcerative colitis patients and 11.5% of controls, presenting an overall sensitivity and specificity for Crohn's disease of 24% and 88%, respectively. Macrophage microaggregates were found in all groups, but were only detected in ulcerative colitis and controls in association with H. pylori infection, with an overall sensitivity and specificity for Crohn's disease of 61% and 69%, respectively. In the absence of H. pylori infection, focally enhanced gastritis and macrophage microaggregates were significantly associated with Crohn's disease (P<0.02 and P = 0.001 respectively).
  
  
  CONCLUSIONS
  Focally gastritis and macrophage microaggregates are suggestive of Crohn's disease only in H. pylori-negative specimens.
authors.affiliation: Serviço de Gastroenterologia, Departamento de Clínica Médica, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro - HUCFF/UFRJ, Rio de Janeiro, RJ, Brasil.
authors.forename: Marcia Henriques de
authors.initials: MH
authors.lastname: Magalhães-Costa
authors.affiliation: Serviço de Gastroenterologia, Departamento de Clínica Médica, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro - HUCFF/UFRJ, Rio de Janeiro, RJ, Brasil.
authors.forename: Beatriz Ribeiro dos
authors.initials: BR
authors.lastname: Reis
authors.affiliation: Departamento de Patologia, Universidade Federal do Rio de Janeiro - HUCFF/UFRJ, Rio de Janeiro, RJ, Brasil.
authors.forename: Vera Lúcia Antunes
authors.initials: VL
authors.lastname: Chagas
authors.affiliation: Nutrition and Immunology Chair, Research Center for Nutrition and Food Sciences (ZIEL), Technische Universität München, Gregor-Mendel-Straße 2, Freising-Weihenstephan, Weihenstephan, Germany.
authors.forename: Tiago
authors.initials: T
authors.lastname: Nunes
authors.affiliation: Serviço de Gastroenterologia, Departamento de Clínica Médica, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro - HUCFF/UFRJ, Rio de Janeiro, RJ, Brasil.
authors.forename: Heitor Siffert Pereira de
authors.initials: HS
authors.lastname: Souza
authors.affiliation: Serviço de Gastroenterologia, Departamento de Clínica Médica, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro - HUCFF/UFRJ, Rio de Janeiro, RJ, Brasil.
authors.forename: Cyrla
authors.initials: C
authors.lastname: Zaltman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000473:pathology*; D003424:Crohn Disease / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D005756:Gastritis / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008264:Macrophages / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D055815:Young Adult