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Published on: October 21, 2014
Pathophysiology in Microvillus inclusion disease
K Reinshagen1, H Naim, G Heusipp
1Kinderchirurgische Klinik, Universitätsklinikum Mannheim. konrad.reinshagen@kch.ma.uni-heidelberg.de
Abstract:
Microvillus inclusion disease (MID) is a congenital disorder with the clinical signs of watery diarrhea often beginning in the first days of life. The main pathological features of the disease include a villus atrophy and an accumulation of periodic acid-Schiff (PAS)-positive material within the apical cytoplasm of enterocytes on the light microscopy level. Electron microscopic criteria are pathognomonic consisting of an increased amount of secretory granules preferentially in crypt epithelial cells and of the presence of microvillus inclusion bodies (MIBs) which are most frequently found in villus enterocytes. Until now the basic molecular defects have not been disclosed completely. In this review we discuss the actual pathogenetic hypothesis and the therapeutic options besides small bowel transplantation.
Insights
Microvillus inclusion disease (MID) causes severe watery diarrhea in newborns. This review covers its pathology, current pathogenetic hypotheses, and treatment options beyond intestinal transplantation.
Area of Science:
- Gastroenterology
- Pediatric Pathology
- Molecular Biology
Background:
- Microvillus inclusion disease (MID) is a rare congenital enteropathy.
- Characterized by severe watery diarrhea from birth.
- Pathological hallmarks include villus atrophy and PAS-positive inclusions.
Purpose of the Study:
- To review current understanding of MID pathogenesis.
- To discuss diagnostic criteria.
- To explore therapeutic strategies.
Main Methods:
- Review of existing literature on Microvillus inclusion disease.
- Analysis of light and electron microscopy findings.
- Discussion of molecular and genetic data.
Main Results:
- Electron microscopy reveals characteristic microvillus inclusion bodies (MIBs) and secretory granules.
- Specific molecular defects underlying MID are still under investigation.
- Pathogenesis involves defects in apical enterocyte differentiation.
Conclusions:
- MID diagnosis relies on characteristic histopathological findings.
- Further research is needed to elucidate molecular causes.
- Management includes supportive care and consideration of small bowel transplantation.
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