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Category: Volume 06 Issue 01 January 2018
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Title: Comparison of efficacy of various stains and immunohistochemistry in diagnosis of amoebic colitis

Authors: Dr Suman Dhakar, Dr Preeti Diwaker, Dr Monika Sharma, Dr Sandip Barman, Dr Kiran Mishra

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i1.137

Abstract

Background: Amoebic colitis is a common parasitic infection especially in developing countries. It’s a devastating disease and should be diagnosed accurately. This study was designed to analyse  compare efficacy & reliability of Haematoxylin & Eosin (H&E), Periodic  acid  schiff’s (PAS), Masson trichrome (MT)and immunohistochemical (IHC) marker in diagnosis of amoebic colitis, and to ascertain advantages and disadvantages of each stain used in amoebic colitis.

Material & Methods: We studied 30 cases reported as amoebic colitis on H&E and 10 cases of non-specific colitis. The pick-up rate of trophozoites of Entamoeba histolytica in H&E, PAS, MT and IHC was compared.

Observation & Results: Out of 30 cases reported as amoebic colitis on H&E, trophozoites were identified in 26 cases of fresh H&E stained slides, in 23 cases with PAS, in 15 cases with MT and 20 out of 30 cases were positive for trophozoites on IHC. Number of trophozoites identified was 5 times on IHC and 2 times on PAS in comparison to H&E. Whereas role of MT was found to be less significant in diagnosing amoebic colitis.

Conclusion: IHC was found to be superior in offering accurate diagnosis of amoebic colitis as it is highly efficacious and gives intense brown colour which makes recognition of trophozoites easier. Our study results suggest that by using IHC marker for amoebic colitis, even complicated cases can be diagnosed easily where they are difficult to be identified using other stains. Another advantage of using IHC is that it curtails false positive diagnosis of amoebiasis on H&E.

Keywords: Amoebic colitis, Immunohistochemistry, Masson’s trichrome, Periodic acid schiff’s.

References

  1. Tan ZN, Wong WK, NikZairi Z, Abdullah B, Rahmah N, Zeehaida M et al. Identification of Entamoeba histolytica trophozoites in fresh stool sample: comparison of three staining techniques and study on the viability period of the trophozoites. Trop Biomed 2010;27:79-88.
  2. Clark, C. G.Entamoeba dispar, an organism reborn. Trans R Soc Trop Med Hyg. 1998; 92: 361-4.
  3. Garcia, L. S., D. A. Bruckner. Diagnostic medical parasitology. 3rd ed. ASM Press Washington D.C. 1997.
  4. Garcia, L. S., D. A. Bruckner. Taxonomy and classification of human parasites, In R. Murray, E. J. Baron, M. A. Pfaller, F. C. Tenover, R. H. Yolken (editor), Manual of clinical microbiology, 7th ed. ASM Press Washington D.C. 1999. pp 1329–1335.
  5. Haque R., I. K. M. Ali, C. G. Clark, W. A. Petri, Jr. A case report of Entamoeba moshkovskii infection in a Bangladeshi child. Parasitol Int 1998; 47: 201-2.
  6. Leber, A. L., S. M. Novak. Intestinal and urogenital amebae, flagellates, and ciliates, In R. Murray, E. J. Baron, M. A. Pfaller, F. C. Tenover, and R. H. Yolken (editor), Manual of clinical microbiology, 7th ed. ASM Press Washington D.C. 1999: pp 1391–1405.
  7. Fritsche, T. R., J. W. Smith. Medical parasitology, p. 1196–1239. In B. Henry (ed.), Clinical diagnosis and management by laboratory methods. 2001. The W. B. Saunders Co., Philadelphia, Pa.
  8. Petri, W. A., Jr., U. Singh. Diagnosis and management of amebiasis. Clin Infect Dis. 1999; 29: 1117-25.
  9. Bancroft JD, Gamble M. Theory and practice of histological techniaques. 5th ed. 2002, China: Churchill Livingstone.
  10. Ralston KS, Petri, WA Jr. Tissue destruction and invasion by Entamoeba histolytica. Trends Parasitol. 2011; 27: 254-63.
  11. Ning TZ, Kin WW, Mustafa S. Detection ofEntamoeba histolytica in experimentally induced amoebic liver abscess: comparison of three staining methods.  Asian Pac J Trop Biomed. 2012; 2: 61-5.
  12. Mukherjee AK, Das K, Bhattacharya MK. Trend of Entamoeba histolytica infestation in Kolkata. Gut pathogen. 2010; 2: 12.
  13. Jain BK, Garg PK, Kumar A. Colonic perforation with peritonitis in amoebiasis: a tropical disease with high mortality. Trop Gastroenterol. 2013; 34: 83-6.
  14. Singla K, Mahajan G, Agarwal S. Role of histopathological examination in nontraumatic perforation of colon. Trop Gastroenterol. 2012; 33: 265-9.
  15. Gilman R, Islam M, Paschi S. Comparison of conventional and immunoflurescent techniques for the detection of Entamoeba histolytica in rectal biopsies. Gastroenterology. 1980; 78: 435-9.
  16. Haque R, Kabir M, Noor Z. Diagnosis of Amebic Liver Abscess and Amoebic Colitis by Detection of  histolytica DNA in Blood, Urine, and Saliva by a Real-Time PCR Assay. J Clin Microbiol. 2010; 48: 2798-2801.
  17. Khairnar K, Parija SC. Detection of Entamoeba histolyticaDNA in the saliva of amoebic liver abscess patients who received prior treatment with metronidazole. J Health Popul Nutr. 2008; 26: 418-25.
  18. Parija SC, Khairnar K. Detection of excretory Entamoeba histolyticaDNA in the urine, and detection of histolyticaDNAand lectin antigen in the liver abscess pus for the diagnosis ofamoebic liver abscess. BMC Microbiol. 2007; 7: 41.
  19. Othman N, Mohamed Z, Verweij JJ, Huat LB, Olivos-Garcia A, Yeng C et al. Application of real-time polymerase chain reaction in detection of Entamoeba histolytica in pus aspirates of liver abscess patients. Foodborne Pathog Dis. 2010; 7: 637-41.
  20. Mitra S, Viswanathan A, Verma S. Fulminant Amoebic colitis: A Rarity in the Pediatric Population. J Microb Biochem Techno. 2016; 8: 166-8.

Corresponding Author

Dr Preeti Diwaker

Assistant Professor, Department of Pathology, 4th Floor, UCMS & GTB Hospital,

Dilshad Garden, Delhi - 110095

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mobile No. : 09971675078