RESUMO
The symptomatology of children with Trichuris Dysentry Syndrome (Ramsey, 1962) has much in common with that of idiopathic inflammatory bowel disease (Crohn's and ulcerative colitis). However, the pathology is confined to the mucosa and includes relatively little disturbance of the crypt architecture or epithelial histology. We undertook an immuno-histochemical study of the faecal mucosa of five heavily infected children with non specific, bloody diarrhoea (in whom such gross inflammatory changes as did exist were confined to the rectum and distal colon). Tissue obtained by colonoscopic biopsy was fixed in formalin and embedded in paraffin wax. Routine histological sections revealed only a non-specific increase in inflammatory cells in the lamina propria and failed to differentiate between trichuriasis and non-specific bloody diarrhoea. Specimens of the fixed tissue were transported to London where a panel of peroxidase-labelled antibodies was applied. Expressing immuno-stained cells as a percentage of total lamina propria cells, we showed marked difference between the Trichuris dysentery and control patients, summarised below using group means: Igm plasma cell, IgE-coated mast cell, Macrophages; TRICHURIS - 12.4, 9.6 33.3 respectively; NON-TRICHURIS - 7.2, 0.5, 8.9 respectively; SIGNIF. LEVEL - 0.05, 0.0001, 0.005 respectively. Further immuno-histochemistry on snap-frozen tissue will allow specification of the type and activation state of the cells involved in the inflammatory response to T. trichiura. It is our hope in due course to relate these changes to the symptomatology, both intestinal and extra-intestinal, of this important disease (AU)
