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World J Gastroenterol. Mar 28, 2009; 15(12): 1493-1498
Published online Mar 28, 2009. doi: 10.3748/wjg.15.1493
Hirschsprung’s disease: Is there a relationship between mast cells and nerve fibers?
Amit Kumar Yadav, Kiran Mishra, Anup Mohta, Sarla Agarwal
Amit Kumar Yadav, Department of Pathology, University College of Medical Sciences, New Delhi 110095, India
Kiran Mishra, Department of Pathology, University College of Medical Sciences, New Delhi 110095, India
Anup Mohta, Department of Paediatric Surgery, Chacha Nehru Baal Chikitsalya, New Delhi 110095, India
Sarla Agarwal, Department of Pathology, University College of Medical Sciences, New Delhi 110095, India
Author contributions: Yadav AK and Mishra K contributed equally to this work; Yadav AK, Mishra K and Agarwal S designed research; Yadav AK, Mishra K and Mohta A performed research; Yadav AK, Mishra K, Agarwal S and Mohta A contributed new reagents/analytic tools; Yadav AK and Mishra K analyzed data; Yadav AK and Mishra K wrote the paper.
Correspondence to: Amit Kumar Yadav, Department of Pathology, University College of Medical Sciences, Dilshad Garden, New Delhi 110095, India. amityadav7284@yahoo.co.in
Telephone: +91-11-22592971-79
Received: October 12, 2008
Revised: January 19, 2009
Accepted: January 26, 2009
Published online: March 28, 2009
Abstract

AIM: To define the topography of mast cells and their numbers in cases of Hirschsprung’s disease (HD) and non-HD, assess neural hypertrophy using imaging software and to study the relationship between mast cells and nerve fibers.

METHODS: HE stained sections of 32 cases of chronic constipation in the age group of 0-14 years were reviewed for ganglion cells. AChE staining was performed on frozen sections of colonic and rectal biopsies. Based on their findings cases were divided into HD and non-HD and mast cells stained by toluidine blue were evaluated. Image analysis by computerized software was applied to S-100 stained sections for assessment of neural hypertrophy.

RESULTS: Difference between number of mast cells in HD group (mean = 36.44) and in non-HD group (mean = 14.79) was statistically significant. Image analysis morphometry on S-100 stained sections served as a useful adjunct. The difference between number, size, and perimeter of the nerve fibers between HD and non-HD group was statistically significant.

CONCLUSION: Mast cells are significantly increased in HD and their base line values are much higher in Indian children than that reported in Western literature. Their role in HD needs further research. Morphometry of S-100 stained nerve fibers is a useful adjunct to conventional methods for diagnosis of HD.

Keywords: Hirschsprung’s disease, Mast cells, S-100, Acetylcholinesterase