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Eosinophils in the gastrointestinal tract: how much is normal?

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Abstract

The normal density of eosinophils in the digestive mucosa of children has been rarely addressed despite being important to provide baseline counts for the diagnosis of eosinophilic gastrointestinal disorders (EGID). Histopathological criteria for EGID remain undefined and there has been little consistency of results in different populations. We aimed to establish the eosinophil density of the normal digestive mucosa in a paediatric population submitted to endoscopic procedures with normal histological features. Biopsies from endoscopies of 33 patients were evaluated. Quantification of eosinophils was performed manually. Review of the pathology reports confirmed absence of abnormality in the biopsy specimens. Counts were expressed in eosinophils per high power field and per mm2. Oesophagus (n = 33): eosinophils were uniformly absent in all biopsies. Stomach: counting was performed, separately, in the superficial and deep lamina propria of the fundus (n = 13), corpus (n = 13) and antrum (n = 16). Mean eosinophilic density was higher in the deep lamina propria. Small intestine: eosinophil counts revealed 18.1 ± 17.0, 14.4 ± 12.0, and 51.5 ± 35.3 in the lamina propria of the bulb (n = 13), D2 (n = 13), and ileum (n = 16), respectively. Large intestine: the highest peak count was observed in the caecum (125 mm2; n = 16) with a mean of 51.8 ± 33.5. The eosinophil counts were lower in the ascending (n = 16; 40.9 ± 27.4), transverse (n = 14; 34.3 ± 21.9), descending (n = 15; 40.0 ± 26.6), and sigmoid (n = 17; 25.8 ± 17.8) colon and in the rectum (n = 17; 13.9 ± 10.1). These data provide a baseline count and distribution of eosinophils in the gastrointestinal tract of paediatric patients with normal mucosa, thus expanding the scarce published data.

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Acknowledgments

The authors would like to acknowledge Mrs. Marta Rodrigues for her great help with the haematoxylin and eosin-stained slides and complete availability.

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Authors and Affiliations

  1. Medical School of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal

    Jorge Silva

  2. Department of Pathology, Centro Hospitalar São João, Porto, Portugal

    Pedro Canão & Fátima Carneiro

  3. Department of Paediatrics, Centro Hospitalar São João, Porto, Portugal

    Maria Céu Espinheira, Eunice Trindade & Jorge Amil Dias

  4. Department of Pathology, Medical School of Porto, Porto, Portugal

    Fátima Carneiro

  5. IPATIMUP, Porto, Portugal

    Fátima Carneiro

  6. i3S, Porto, Portugal

    Fátima Carneiro

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  1. Jorge Silva
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Correspondence to Jorge Silva.

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Silva, J., Canão, P., Espinheira, M.C. et al. Eosinophils in the gastrointestinal tract: how much is normal?. Virchows Arch 473, 313–320 (2018). https://doi.org/10.1007/s00428-018-2405-2

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