ABSTRACT
Two cases with typical clinical and histological manifestations of Whipple's disease were reported. Peroral jejunal biopsies were studied in the florid stage and during remission achieved by tetracycline therapy. A complete absence of immunoglobulin-containing cells (Ig-CC) and an increased number of mast cells in the mucosa were established in one of the cases. A 5-fold decrease of the mucosal Ig-CC was found by immunofluorescent morphometry in the second case. An increased Ig-CC number and histological restitution of the mucosa were shown in the first case during remission, whereas histological alterations and decreased Ig-CC number persisted in the second case despite of clinical improvement. The HLA-locus B27 was not available in the reported cases.
Subject(s)
Intestinal Mucosa/pathology , Whipple Disease/diagnosis , Female , Fluorescent Antibody Technique , Humans , Immunoglobulins/metabolism , Jejunum/pathology , Macrophages/ultrastructure , Male , Microvilli/ultrastructure , Middle Aged , Whipple Disease/pathologyABSTRACT
A simplified immunofluorescent morphometric technique for quantitative determination of immunoglobulin-forming cells (Ig-FC) in the small intestine mucosa was described. The following average values were established in 19 cases with chronic enteritis: total amount of Ig-FC: 117.5/0.1 mm2 villous area; IgA-FC = 78.4%, IgM-FC = 15.6%, and IgG-FC = 4.8%. An increased number of Ig-FC was found in a case with the syndrome of Peutz-Jeghers and in a case with alcoholic pancreatitis. Relatively high percentages of IgM-FC were established in two cases with long lasting chronic enterocolitis. The immunofluorescent study was performed simultaneously with the routine histology on the same biopsy specimens.
Subject(s)
Immunoglobulins/biosynthesis , Intestine, Small/immunology , Adolescent , Adult , Antibody Formation , Biopsy , Chronic Disease , Enteritis/immunology , Enteritis/pathology , Female , Fluorescent Antibody Technique , Humans , Immunoglobulin A , Immunoglobulin G , Immunoglobulin M , Intestine, Small/cytology , Male , Middle AgedABSTRACT
A case with nodular lymphoid hyperplasia of the jejunal mucosa associated with hypo- and dysgammaglobulinemia, increased susceptibility to infections, recurrent giardia invasions, absence of plasma cells in the bone marrow and jejunal mucosal stroma and extremely increased number of mucosal mast cells has been described. The latter was supposed to be an essential morphological feature of the syndrome, that is due to a "secondary" response to repeated giardia invasions in a condition of impaired humoral but presumably normal cellular immune response. Some of the tinctorial properties of intestinal mucosal mast cells were discussed.
Subject(s)
Agammaglobulinemia/immunology , Intestinal Mucosa/pathology , Jejunum/pathology , Lymphatic Diseases/immunology , Mast Cells/ultrastructure , Female , Humans , Hyperplasia , Intestinal Mucosa/immunology , Lymphatic Diseases/pathology , Middle Aged , SyndromeABSTRACT
An immunofluorescent and histologic morphometric study of jejunum biopsy specimens has been performed. Following data were taken into consideration; immunoglobulin-containing cells (Ig-CC) per 0.1 mm2 mucosal stroma, absolute quantities and percentage of IgA-, IgM- and IgG-CC, interepithelial lymphocytes (Ie-L) per 1 mm length of muscularis mucosae, dimensions of villi and intervillous area. Relatively low Ig-CC values were established in some cases with chronic enterocolitis, whereas higher Ig-CC counts were found in cases with different other enteropathies, including gluten-sensitive enteropathy. Irrespective from the varying Ig-CC values, the percentage of IgA-CC was relatively constant. The percentage of IgM- and IgG-CC was subjected to significant variations. In chronic enteropathies with advanced villous atrophy and increased intervillous area increased IgM- and IgG-CC values were established. There was no significant correlation between mucosal atrophy, Ig-CC and Ie-L values, except in cases with gluten-sensitive enteropathy.
