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Calretinin immunohistochemistry: A new cost-effective and easy method for diagnosis of Hirschsprung's disease.

Kannaiyan L, Madabhushi S, Malleboyina R, Are NK, Reddy KR, Rao B - J Indian Assoc Pediatr Surg (2013)

Bottom Line: Ganglion cells were found in 3 specimens and nerve fibers in 5.Calretinin was extremely useful in solving the suspicious and indeterminate cases of HD.It can serve as a valuable cost-effective diagnostic aid in the centers where acetylcholinesterase enzyme histochemistry is not available.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Surgery, Niloufer Hospital for Women and Children, Osmania Medical College, Hyderabad, India.

ABSTRACT

Aim: To evaluate the efficacy of calretinin immunostaining in diagnosing Hirschsprung's disease (HD).

Materials and methods: Sixty cases were studied over a period of 1 year (July 2010-June 2011). There were 36 full-thickness biopsies and 24 resected specimens. Calretinin processing was done on the paraffin-embedded blocks after routine histopathological examination.

Results: Of the 36 biopsy specimens, in 19 cases HD was diagnosed by hematoxylin and eosin (H and E) staining earlier. In 2 patients, ganglion cells were seen and HD was ruled out. In 15 cases, there was a diagnostic dilemma and calretinin was used. Ganglion cells were found in 3 specimens and nerve fibers in 5. In all 24 resected specimens, calretinin correlated with the findings on H and E staining.

Conclusions: Calretinin was extremely useful in solving the suspicious and indeterminate cases of HD. It can serve as a valuable cost-effective diagnostic aid in the centers where acetylcholinesterase enzyme histochemistry is not available.

No MeSH data available.


Related in: MedlinePlus

Hematoxylin and eosin section with ganglion cell (arrow) (H and E, 10×)
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Figure 1: Hematoxylin and eosin section with ganglion cell (arrow) (H and E, 10×)

Mentions: Calretinin is proven to be highly sensitive for the presence of ganglion cells and nerve fibers.[67] This protein is involved in calcium transport; and its absence allows accumulation of cytoplasmic calcium, causing excess neuroexcitability and ultimate neurodegeneration. Barshack, et al.,[7] procured the colons of 10 patients with proven HD. Calretinin IHC was performed on sections from the aganglionic zone, ganglionic zone, and transition zone of these colons. They identified calretinin staining in interstitial nerve fibres (INF) and ganglion cells in normal colon [Figures 1 and 2] and focal INF staining in 92% of transition zones. In contrast, there was no INF or ganglion cell staining in the aganglionic zone. It is easily applied to paraffin-embedded specimens. It can be interpreted as positive or negative for immune reactivity reducing the ambiguity in diagnosis. In our study, in the rectal biopsy specimens, diagnosis was ambiguous in 15 patients on H and E examination. By using calretinin, immune positivity was demonstrated in 3 patients (3 for ganglion cells and 5 for nerve fibers); thereby, ruling out HD in these patients.


Calretinin immunohistochemistry: A new cost-effective and easy method for diagnosis of Hirschsprung's disease.

Kannaiyan L, Madabhushi S, Malleboyina R, Are NK, Reddy KR, Rao B - J Indian Assoc Pediatr Surg (2013)

Hematoxylin and eosin section with ganglion cell (arrow) (H and E, 10×)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3687149&req=5

Figure 1: Hematoxylin and eosin section with ganglion cell (arrow) (H and E, 10×)
Mentions: Calretinin is proven to be highly sensitive for the presence of ganglion cells and nerve fibers.[67] This protein is involved in calcium transport; and its absence allows accumulation of cytoplasmic calcium, causing excess neuroexcitability and ultimate neurodegeneration. Barshack, et al.,[7] procured the colons of 10 patients with proven HD. Calretinin IHC was performed on sections from the aganglionic zone, ganglionic zone, and transition zone of these colons. They identified calretinin staining in interstitial nerve fibres (INF) and ganglion cells in normal colon [Figures 1 and 2] and focal INF staining in 92% of transition zones. In contrast, there was no INF or ganglion cell staining in the aganglionic zone. It is easily applied to paraffin-embedded specimens. It can be interpreted as positive or negative for immune reactivity reducing the ambiguity in diagnosis. In our study, in the rectal biopsy specimens, diagnosis was ambiguous in 15 patients on H and E examination. By using calretinin, immune positivity was demonstrated in 3 patients (3 for ganglion cells and 5 for nerve fibers); thereby, ruling out HD in these patients.

Bottom Line: Ganglion cells were found in 3 specimens and nerve fibers in 5.Calretinin was extremely useful in solving the suspicious and indeterminate cases of HD.It can serve as a valuable cost-effective diagnostic aid in the centers where acetylcholinesterase enzyme histochemistry is not available.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Surgery, Niloufer Hospital for Women and Children, Osmania Medical College, Hyderabad, India.

ABSTRACT

Aim: To evaluate the efficacy of calretinin immunostaining in diagnosing Hirschsprung's disease (HD).

Materials and methods: Sixty cases were studied over a period of 1 year (July 2010-June 2011). There were 36 full-thickness biopsies and 24 resected specimens. Calretinin processing was done on the paraffin-embedded blocks after routine histopathological examination.

Results: Of the 36 biopsy specimens, in 19 cases HD was diagnosed by hematoxylin and eosin (H and E) staining earlier. In 2 patients, ganglion cells were seen and HD was ruled out. In 15 cases, there was a diagnostic dilemma and calretinin was used. Ganglion cells were found in 3 specimens and nerve fibers in 5. In all 24 resected specimens, calretinin correlated with the findings on H and E staining.

Conclusions: Calretinin was extremely useful in solving the suspicious and indeterminate cases of HD. It can serve as a valuable cost-effective diagnostic aid in the centers where acetylcholinesterase enzyme histochemistry is not available.

No MeSH data available.


Related in: MedlinePlus