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Challenges in the diagnosis of intestinal neuronal dysplasia type B:A look beyond the number of ganglion cells

查看全文 作　　者：Simone Antunes [1]Terra;Anderson Cesar [2]Gonçalves;Pedro Luiz Toledo de Arruda [2]Lourenção;Maria [1]Aparecida;Marchesan [1]Rodrigues 高影响力作者 机构地区：[1]Department of Pathology,Faculty of Medicine,São Paulo State University(UNESP),Botucatu 18618687,São Paulo,Brazil;[2]Department of Surgery and Orthopedics,Botucatu Medical School-São Paulo State University(UNESP),Botucatu 18618970,São Paulo,Brazil高影响力机构 出　　处：《World Journal of Gastroenterology》索引2021年第27卷第44期,共12页高影响力期刊 基　　金：São Paulo Research Foundation(FAPESP),No.2017/26205-9. 摘　　要：Intestinal neuronal dysplasia type B(IND-B)is a controversial condition among gastrointestinal neuromuscular disorders.Constipation is its most common clinical manifestation in patients.Despite intense scientific research,there are still knowledge gaps regarding the diagnostic criteria for IND-B in the histopathological analysis of rectal biopsies.The guidelines published in the past three decades have directed diagnostic criteria for quantifying the number of ganglion cells in the nervous plexus of the enteric nervous system.However,it is very complex to distinguish numerically what is pathological from what is normal,mainly because of the difficulty in determining a reliable control group composed of healthy children without intestinal symptoms.Thus,a series of immunohistochemical markers have been proposed to assist in the histopathological analysis of the enteric nervous system.Several of these markers facilitate the identification of other structures of the enteric nervous system,in addition to ganglion cells.These structures may be related to the etiopathogenesis of IND-B and represent new possibilities for the histopathological diagnosis of this disease,providing a view beyond the number of ganglion cells.This review critically discusses the aspects related to the disease definitions and diagnostic criteria of this organic cause of constipation. 关 键 词：Intestinal neuronal dysplasia type B CONSTIPATION DIAGNOSIS Gastrointestinal neuromuscular diseases
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