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Histochemical studies on rectal mucosa in active intestinal schistosomiasis.
S S el-Din1, M M Massoud, S Hossny
1Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Egypt.
Journal of the Egyptian Society of Parasitology
|August 1, 1991
Summary
Schistosomiasis mansoni infection alters rectal mucosa, affecting goblet cells and nerve fibers. Severity correlates with disease progression and parasite load.
Area of Science:
- Medical Parasitology
- Gastroenterology
- Histopathology
Background:
- Intestinal schistosomiasis mansoni (S. mansoni) is a significant public health concern.
- Understanding the histopathological and histochemical changes in the rectal mucosa is crucial for disease staging and management.
Purpose of the Study:
- To investigate the histopathological and histochemical alterations in the rectal mucosa of patients with varying stages of intestinal S. mansoni infection.
- To correlate these changes with disease severity and parasite burden.
Main Methods:
- Histopathological examination of rectal biopsies from 30 S. mansoni infected patients (categorized into early, hepatosplenomegalic, and ascitic groups) and 10 controls.
- Histochemical staining (Periodic Acid Schiff, Alkaline Phosphatase, Acetylcholinesterase) to assess mucin content, enzyme activity, and nerve fiber integrity.
- Correlation of findings with clinical presentation (hepatosplenomegaly, ascites) and infection intensity.
Main Results:
- Early S. mansoni infection showed hyperaemia and extravasation of blood; later stages exhibited granulomatous lesions and severe structural changes, including distorted mucosal glands.
- Periodic Acid Schiff staining revealed reduced neutral mucin in goblet cells of advanced (ascitic) cases, with intensity varying by infection load.
- Alkaline phosphatase was localized to S. mansoni eggshells, not rectal crypts. Acetylcholinesterase staining showed a significant decrease in nerve fibers, more pronounced in chronic and heavily infected patients.
Conclusions:
- Histopathological and histochemical changes in the rectal mucosa reflect the progression of intestinal S. mansoni infection.
- Goblet cell mucin depletion and reduced acetylcholinesterase activity in nerve fibers are indicators of advanced disease and higher parasite burden.
- These findings highlight the utility of rectal mucosal analysis in assessing schistosomiasis severity and its pathological impact.