Khudhair, S., Al Saadawi, A. (2020). The Utility of Calretinin Immunohistochemistry in the Diagnosis of Hirschsprung’s Disease. , 19(4), 338-344. doi: 10.52573/ipmj.2020.167328
Safa Majid Khudhair; Adil Rabea Al Saadawi. "The Utility of Calretinin Immunohistochemistry in the Diagnosis of Hirschsprung’s Disease". , 19, 4, 2020, 338-344. doi: 10.52573/ipmj.2020.167328
Khudhair, S., Al Saadawi, A. (2020). 'The Utility of Calretinin Immunohistochemistry in the Diagnosis of Hirschsprung’s Disease', , 19(4), pp. 338-344. doi: 10.52573/ipmj.2020.167328
Khudhair, S., Al Saadawi, A. The Utility of Calretinin Immunohistochemistry in the Diagnosis of Hirschsprung’s Disease. , 2020; 19(4): 338-344. doi: 10.52573/ipmj.2020.167328

The Utility of Calretinin Immunohistochemistry in the Diagnosis of Hirschsprung’s Disease

Iraqi Postgraduate Medical Journal
Article 10, Volume 19, Issue 4, 2020, Pages 338-344    PDF (1.05 M)
DOI: 10.52573/ipmj.2020.167328
Authors
Safa Majid Khudhair* 1; Adil Rabea Al Saadawi2
1Al-Wasiti Teaching Hospital, Baghdad- Iraq
2Teaching Laboratories- Medical City, Baghdad/Iraq
Abstract
BACKGROUND:
Hirschsprung’s  disease  (HD)  is  a  congenital  intestinal  motility  disorder  with absence  of  ganglion  cells  in  the  colonic  wall, Diagnosis of the disease is based primarily on histopathological analysis, but in this respect,  there are limitations associated with standard histology and histochemistry. Calretinin immunohistochemistry (IHC) was implemented to solve the diagnostic problems of this disease as a diagnostic marker.
OBJECTIVE:
We aimed to test, identify and compare the immunostaining calretinin in the aganglionic segment of colon specimens and to assess the diagnostic importance of the process with the normoganglionic segment (control group).
PATIENTS AND METHODS:
The specimens contained 40 patients with HD histopathology and 20 others (as a control group) who were colectomied for other reasons,60 paraffin wax blocks were analyzed for full-blown bowel specimens and rectum biopsy. Sixty) paraffin wax) blocksof full bowel thickness and rectal biopsy were examined. In IHC stained slides, calretinine immunoreactivity and pattern of stain for ganglion cells( nuclear  and  cytoplasmic)and nerve fibers in different bowel layers were assessed. 
RESULTS:
Calreinin Immunostaining was positive of  ganglion  cells(nuclear and  cytoplasmic  staining) and nerve  fibers  in  the mucosa)  lamina  propria(, submucosa  and  muscularis  propria  in  all  specimens of control group except one case (2.5 percent), calretinin immunoexpression of ganglion cells and nerve fibers was negatively(-) ,In aganglionic segments (case group).This  method  had  sensitivity  of 97.5%  and  specificity  of  100%  for  diagnosis  of  HD.  The  positive  predictive value was  100%  and  negative predictive  value was  95.2%.
CONCLUSION:
Immunohistochemistry Calretinin can be used for the diagnosis of HD as a dependable and ancillary method.
 
Keywords
Hirschsprung disease; Calretinin; Immunohistochemistry
References
REFERENCES:

  1. Geram-  izadeh  B,  Akbarzadeh  E,  Izadi  B,  Foroutan  HR,  Heidari  T. Immunohistochemical  study  of  enteric  nervous  system  in  hirschsprung’s disease  and  intestinal  neuronal  dysplasia.  Histol  His-  topathol. 2013;28(3):345-347.
  2. Kapur  RP.  Practical  pathology  and  genetics  of  Hirschsprung's  disease. Semin  Pediatr Surg  2009;  18:212-223.
  3. Kaçar,  A.,  Arikok,  A.T.,  Azili,  M.N.,  Ekberli  Agirbas,  G.  &  Tiryaki,  T. Calretinin  immunohistochemistry  in  Hirschsprung's  disease:  An  adjunct to  formalin-based  diagnosis.  Turk  J Gastroenterol(2012),23:226-33
  4. Kapur  RP.  Can  we  stop  looking?  Immunohistochemistry  and  the diagnosis  of Hirschsprung  disease.  Am  J Clin  Pathol.  2006;126(1):9.
  5. Singh  SJ,  Croaker  GD,  Manglick  P,  Wong  CL,  Atha-  nasakos  H,  Elliott E,  et  al.  Hirschsprung’s  disease:  the  Australian  Paediatric  Surveillance Unit’s  experience.  Pediatr Surg  Int.  2003;19:247-251.
  6. Shamsuddin  AM,  Phelps  PC,  Trump  BF.  Human  large  intestinal epithelium:  light  microscopy,  histochemistry,  and  ultrastructure.  Hum Pathol.  1982;13(9):790-803.
  7. Rakhshani  N,  Araste  M,  Imanzade  F,  Panahi  M,  Safarnezhad  Tameshkel F,  Sohrabi  MR,  et  al.  Hirschsprung  Disease  Diagnosis:  Calretinin  Marker Role  in  Determining  the  Presence  or  Absence  of  Ganglion  Cells.  Iran  J Pathol  2016;  11(4):409-415.
  8. The  loss  of  calretinin  expression  indicates  aganglionosis  in Hirschsprung’s  disease.   arshack  I,  Fridman  E,  Goldberg  I,  Chow-  ers  Y, Kopolovic  J.  J  Clin  Pathol.  2004;57(7):712.
  9. Klein  MD,  Philippart  AI.  Hirschsprung's  disease  three  decades experience at  a  single   institution,  J  Pediatr  Surg  1993,28  (10)  41291-3.
  10. Hiradfar  M,  Shari    N,  Khajedaluee  M,  Zabolinejad  N,  Taraz  Jamshidi  S. Calretinin  immunohistochemistery:  an  aid  in  the  diagnosis  of Hirschsprung’s  disease.  Iran  J  asic Med  Sci 2012;15(5):1053-9.
  11. Mohsen  Rouzrokh  ,  MD  ;  Farzaneh  Jadali,  MD  ;  Atoosa  Gharib,  MD  ; Ahmad  Khaleghnejad-Tabari  ,  MD  ;  Azita  Tavassoli  ,  MD  ;  Leily Mohajerzadeh  ,  MD  :  Iran  J  PEDIATR  March  2011;vol  21  (  no  1)  , Pp:72-70.
  12. Mohammad  Hossein  Anbardar  ;  Bita  Geramizadeh  ,  Hamid  Reza Foroutan,et  al  Evaluation  of  Calretinin  as  a  New  Marker  in  the  Diagnosis of Hirschsprung  Disease.  Iran  J Pediatr.  2015;25(2):e367  .
  13. Kapur, R.P.  et  al.  Calretinin  immunohistochemistry  versus acetylcholinesterase  histochemistry  in  the  evaluation  of  suction  rectal biopsies  for Hirschsprung  Disease.  Pediatr  Dev  Pathol,2009;12,  6-15.
  14. Guinard-Samuel  V,  Bonnard  A,  De  Lagausie  P,  Philippe-Chomette  P, Alberti  C,  El  Ghoneimi  A,  et  al.  Calretinin  immunohistochemistry:  a simple  and  efficient  tool  to  diagnose  Hirschsprung  disease.  Mod  Pathol 2009;  22:1379-1384.
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