Endometrial plasma cells: do they indicate subclinical pelvic inflammatory disease?
Sharon L Achilles1, Antonio J Amortegui, Harold C Wiesenfeld
1School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
Background:
Subclinical pelvic inflammatory disease (PID) is a common condition among women with lower genital tract infection and is believed to be responsible for a greater proportion of PID-related sequelae than acute PID. Subclinical PID is diagnosed histologically after endometrial biopsy. In the literature, many different histologic criteria have been used to define subclinical PID.
Goal:
To determine if endometrial plasma cells are commonly found in women at low likelihood of PID.
Study:
A cross-sectional study of 33 women undergoing tubal ligation and at low likelihood of PID was performed. At the time of tubal ligation, study participants underwent visualization of pelvic organs and an endometrial biopsy, which was analyzed for the presence of neutrophils and plasma cells. Demographic, clinical, and microbiologic data were compared among women with and without endometrial plasma cells.
Results:
Endometrial plasma cells were identified in one third (33%) of the asymptomatic, fertile, healthy women in our cohort. The presence of plasma cells was not associated with lower genital tract infection, including bacterial vaginosis. Laparoscopic evidence of fallopian tube damage was similar in patients with and without endometrial plasma cells (22% in each group).
Conclusion:
Plasma cells are commonly found in the endometria of healthy women and may not represent upper genital tract inflammation.
Insights
Plasma cells are common in the endometria of healthy women, even without signs of pelvic inflammatory disease (PID). This finding suggests that their presence may not always indicate upper genital tract inflammation.
Area of Science:
- Gynecology
- Reproductive Health
- Pathology
Background:
- Subclinical pelvic inflammatory disease (PID) is frequently associated with lower genital tract infections.
- Histological examination of endometrial biopsy is used to diagnose subclinical PID.
- Existing literature shows variability in histological criteria for defining subclinical PID.
Purpose of the Study:
- To investigate the prevalence of endometrial plasma cells in women with a low risk of PID.
- To assess whether endometrial plasma cells are a common finding in healthy women.
Main Methods:
- A cross-sectional study involved 33 women undergoing tubal ligation with low PID likelihood.
- Pelvic organ visualization and endometrial biopsies were performed during tubal ligation.
- Endometrial biopsies were analyzed for neutrophils and plasma cells; demographic, clinical, and microbiologic data were compared.
Main Results:
- Endometrial plasma cells were detected in one-third of asymptomatic, healthy women.
- The presence of plasma cells was not linked to lower genital tract infections like bacterial vaginosis.
- Fallopian tube damage, assessed laparoscopically, was similar in women with and without endometrial plasma cells (22% in both groups).
Conclusions:
- Plasma cells are frequently observed in the endometria of healthy women.
- The presence of endometrial plasma cells may not necessarily indicate upper genital tract inflammation.
- This challenges the assumption that endometrial plasma cells are solely indicative of PID.
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