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Eosinophilia in the upper gastrointestinal tract is not a characteristic feature in cow's milk sensitive gastro-oesophageal reflux disease. Measurement by two methodologies.
J Clin Pathol 2006; 59(1):89-94JC

Abstract

BACKGROUND

An association between cow's milk hypersensitivity (CMH) and gastro-oesophageal reflux disease (GERD) in childhood has been reported in the past decade.

AIM

To assess whether biopsies from the upper gastrointestinal tract of children with cow's milk sensitive GERD have a specific allergic inflammatory pattern, and to compare two different techniques for measuring inflammatory cells in gastrointestinal biopsies.

METHODS

GERD was diagnosed by means of endoscopy and oesophageal pH monitoring. Hypersensitivity to cow's milk was determined by an elimination diet and cow's milk challenge. Allergic inflammatory cells in upper gastrointestinal biopsies were identified by immunohistochemistry and their numbers were assessed by two different methods-counting the number of cells/high power field and using the computerised Cast-Grid system.

RESULTS

Cow's milk sensitive GERD was identified in 10 of 17 children with severe GERD (median age, 7.8 years). Biopsies from children with endoscopic oesophagitis had significantly increased numbers of mast cells and T cells. No differences in the number of eosinophils, mast cells, or T cells were found between children with CMH and those with primary GERD. Several differences were found between the two different histological quantification methods.

CONCLUSIONS

CMH was found not only in infants but also in school age children with GERD. Histology did not identify the cow's milk sensitive GERD subgroup. The computerised histological method provides a more complete evaluation based upon total biopsy area, and helped to limit the bias of uneven biopsy size.

Authors+Show Affiliations

Department of Paediatrics, Odense University Hospital, Sdr. Boulevard 29, Dk-5000 Odense C, Denmark. rgn@dadlnet.dkNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16394287

Citation

Nielsen, R G., et al. "Eosinophilia in the Upper Gastrointestinal Tract Is Not a Characteristic Feature in Cow's Milk Sensitive Gastro-oesophageal Reflux Disease. Measurement By Two Methodologies." Journal of Clinical Pathology, vol. 59, no. 1, 2006, pp. 89-94.
Nielsen RG, Fenger C, Bindslev-Jensen C, et al. Eosinophilia in the upper gastrointestinal tract is not a characteristic feature in cow's milk sensitive gastro-oesophageal reflux disease. Measurement by two methodologies. J Clin Pathol. 2006;59(1):89-94.
Nielsen, R. G., Fenger, C., Bindslev-Jensen, C., & Husby, S. (2006). Eosinophilia in the upper gastrointestinal tract is not a characteristic feature in cow's milk sensitive gastro-oesophageal reflux disease. Measurement by two methodologies. Journal of Clinical Pathology, 59(1), pp. 89-94.
Nielsen RG, et al. Eosinophilia in the Upper Gastrointestinal Tract Is Not a Characteristic Feature in Cow's Milk Sensitive Gastro-oesophageal Reflux Disease. Measurement By Two Methodologies. J Clin Pathol. 2006;59(1):89-94. PubMed PMID: 16394287.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Eosinophilia in the upper gastrointestinal tract is not a characteristic feature in cow's milk sensitive gastro-oesophageal reflux disease. Measurement by two methodologies. AU - Nielsen,R G, AU - Fenger,C, AU - Bindslev-Jensen,C, AU - Husby,S, PY - 2006/1/6/pubmed PY - 2006/2/17/medline PY - 2006/1/6/entrez SP - 89 EP - 94 JF - Journal of clinical pathology JO - J. Clin. Pathol. VL - 59 IS - 1 N2 - BACKGROUND: An association between cow's milk hypersensitivity (CMH) and gastro-oesophageal reflux disease (GERD) in childhood has been reported in the past decade. AIM: To assess whether biopsies from the upper gastrointestinal tract of children with cow's milk sensitive GERD have a specific allergic inflammatory pattern, and to compare two different techniques for measuring inflammatory cells in gastrointestinal biopsies. METHODS: GERD was diagnosed by means of endoscopy and oesophageal pH monitoring. Hypersensitivity to cow's milk was determined by an elimination diet and cow's milk challenge. Allergic inflammatory cells in upper gastrointestinal biopsies were identified by immunohistochemistry and their numbers were assessed by two different methods-counting the number of cells/high power field and using the computerised Cast-Grid system. RESULTS: Cow's milk sensitive GERD was identified in 10 of 17 children with severe GERD (median age, 7.8 years). Biopsies from children with endoscopic oesophagitis had significantly increased numbers of mast cells and T cells. No differences in the number of eosinophils, mast cells, or T cells were found between children with CMH and those with primary GERD. Several differences were found between the two different histological quantification methods. CONCLUSIONS: CMH was found not only in infants but also in school age children with GERD. Histology did not identify the cow's milk sensitive GERD subgroup. The computerised histological method provides a more complete evaluation based upon total biopsy area, and helped to limit the bias of uneven biopsy size. SN - 0021-9746 UR - https://www.unboundmedicine.com/medline/citation/16394287/Eosinophilia_in_the_upper_gastrointestinal_tract_is_not_a_characteristic_feature_in_cow's_milk_sensitive_gastro_oesophageal_reflux_disease__Measurement_by_two_methodologies_ L2 - http://jcp.bmj.com/cgi/pmidlookup?view=long&pmid=16394287 DB - PRIME DP - Unbound Medicine ER -