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. 1985 Oct;38(10):1119–1126. doi: 10.1136/jcp.38.10.1119

Defining duodenitis: quantitative histological study of mucosal responses and their correlations.

D Jenkins, A Goodall, F R Gillet, B B Scott
PMCID: PMC499452  PMID: 4056067

Abstract

Biopsies from 56 patients with endoscopically normal duodenal bulbs, duodenitis, or duodenal ulceration were studied for counts of plasma cells, polymorphs, and eosinophils and extent of gastric metaplasia, villous atrophy, and mucosal oedema. A correlation matrix showed that the counts of different types of plasma cells were closely correlated with each other and that there was also a close correlation between the presence of intraepithelial polymorphs, villous atrophy, and gastric metaplasia. Cluster and discriminant analysis indicated that the histological changes could be grouped by their statistical association into three simple categories: normal, which includes many cases incorrectly labelled in some classification systems as mild or chronic duodenitis; histologically defined mild duodenitis, characterised by an appreciable plasma cell response and oedema usually with intraepithelial polymorph infiltration and gastric metaplasia; and severe duodenitis, with an appreciable polymorph response and villous atrophy but decreased plasma cells. Decreased plasma cells may be an important indication of peptic ulceration.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cotton P. B., Price A. B., Tighe J. R., Beales J. S. Preliminary evaluation of "duodenitis" by endoscopy and biopsy. Br Med J. 1973 Aug 25;3(5877):430–433. doi: 10.1136/bmj.3.5877.430. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Curran R. C., Gregory J. The unmasking of antigens in paraffin sections of tissue by trypsin. Experientia. 1977 Oct 15;33(10):1400–1401. doi: 10.1007/BF01920206. [DOI] [PubMed] [Google Scholar]
  3. Gear E. V., Jr, Dobbins W. O., 3rd The histologic spectrum of proximal duodenal biopsy in adult males. Am J Med Sci. 1969 Feb;257(2):90–93. doi: 10.1097/00000441-196902000-00003. [DOI] [PubMed] [Google Scholar]
  4. Greenlaw R., Sheahan D. G., DeLuca V., Miller D., Myerson D., Myerson P. Gastroduodenitis. A broader concept of peptic ulcer disease. Dig Dis Sci. 1980 Sep;25(9):660–672. doi: 10.1007/BF01308325. [DOI] [PubMed] [Google Scholar]
  5. Hasan M., Hay F., Sircus W., Ferguson A. Nature of the inflammatory cell infiltrate in duodenitis. J Clin Pathol. 1983 Mar;36(3):280–288. doi: 10.1136/jcp.36.3.280. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hasan M., Sircus W., Ferguson A. Duodenal mucosal architecture in non-specific and ulcer-associated duodenitis. Gut. 1981 Aug;22(8):637–641. doi: 10.1136/gut.22.8.637. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Joffe S. N., Lee F. D., Blumgart L. H. Duodenitis. Clin Gastroenterol. 1978 Sep;7(3):635–650. [PubMed] [Google Scholar]
  8. Jones J. H., Lennard-Jones J. E., Morson B. C., Chapman M., Sackin M. J., Sneath P. H., Spicer C. C., Card W. I. Numerical taxonomy and discriminant analysis applied to non-specific colitis. Q J Med. 1973 Oct;42(168):715–732. [PubMed] [Google Scholar]
  9. Kirkegaard P., Olsen P. S., Poulsen S. S., Nexø E. Epidermal growth factor inhibits cysteamine-induced duodenal ulcers. Gastroenterology. 1983 Dec;85(6):1277–1283. [PubMed] [Google Scholar]
  10. Kreuning J., Bosman F. T., Kuiper G., Wal A. M., Lindeman J. Gastric and duodenal mucosa in 'healthy' individuals. An endoscopic and histopathological study of 50 volunteers. J Clin Pathol. 1978 Jan;31(1):69–77. doi: 10.1136/jcp.31.1.69. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Patrick W. J., Denham D., Forrest A. P. Mucous change in the human duodenum: a light and electron microscopic study and correlation with disease and gastric acid secretion. Gut. 1974 Oct;15(10):767–776. doi: 10.1136/gut.15.10.767. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. RHODES J. EXPERMENTAL PRODUCTION OF GASTRIC EPITHELIUM IN THE DUODENUM. Gut. 1964 Oct;5:454–458. doi: 10.1136/gut.5.5.454. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Scott B. B., Losowsky M. S. Peroral small-intestinal biopsy: experience with the hydraulic multiple biopsy instrument in routine clinical practice. Gut. 1976 Sep;17(9):740–743. doi: 10.1136/gut.17.9.740. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Shousha S., Parkins R. A., Bull T. B. Chronic duodenitis with gastric metaplasia: electron microscopic study including comparison with normal. Histopathology. 1983 Nov;7(6):873–885. doi: 10.1111/j.1365-2559.1983.tb02302.x. [DOI] [PubMed] [Google Scholar]
  15. Shousha S., Spiller R. C., Parkins R. A. The endoscopically abnormal duodenum in patients with dyspepsia: biopsy findings in 60 cases. Histopathology. 1983 Jan;7(1):23–34. doi: 10.1111/j.1365-2559.1983.tb02213.x. [DOI] [PubMed] [Google Scholar]
  16. Silcocks P. B. Measuring repeatability and validity of histological diagnosis--a brief review with some practical examples. J Clin Pathol. 1983 Nov;36(11):1269–1275. doi: 10.1136/jcp.36.11.1269. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Taylor C. R. Immunoperoxidase techniques: practical and theoretical aspects. Arch Pathol Lab Med. 1978 Mar;102(3):113–121. [PubMed] [Google Scholar]
  18. Thomson W. O., Joffe S. N., Robertson A. G., Lee F. D., Imrie C. W., Blumgart L. H. Is duodenitis a dyspeptic myth? Lancet. 1977 Jun 4;1(8023):1197–1198. doi: 10.1016/s0140-6736(77)92729-5. [DOI] [PubMed] [Google Scholar]
  19. Whitehead R., Roca M., Meikle D. D., Skinner J., Truelove S. C. The histological classification of duodenitis in fibreoptic biopsy specimens. Digestion. 1975;13(3):129–136. doi: 10.1159/000197701. [DOI] [PubMed] [Google Scholar]

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