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Ultrastructural abnormalities in endoscopically and histologically normal and involved colon in ulcerative colitis
G Delpre1, I Avidor, R Steinherz
1J. Casper Department of Pathology, Beilinson Medical Center, Petah Tikva, Israel.
The American Journal of Gastroenterology
|September 1, 1989
Summary
Electron microscopy reveals widespread colonic epithelial cell abnormalities in ulcerative colitis, even in clinically inactive disease. These sub-microscopic changes highlight the need for ongoing maintenance therapy.
Area of Science:
- Gastroenterology
- Cell Biology
- Pathology
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Endoscopic and light microscopy are standard diagnostic tools for UC.
- Understanding sub-mucosal changes is crucial for UC management.
Purpose of the Study:
- To compare endoscopic findings with light and electron microscopic features in UC biopsies.
- To investigate the cellular abnormalities in UC, including in clinically unaffected areas.
Main Methods:
- Twenty colonoscopies were performed on 15 patients with UC.
- Biopsies were taken from multiple colonic sites for light and electron microscopy.
- Patient preparation varied based on disease severity.
Main Results:
- A high correlation (94.7%) was found between endoscopic and light microscopic findings.
- Electron microscopy revealed significant ultrastructural changes in colonic epithelial cells, exceeding light microscopy.
- Abnormalities were detected in endoscopically and histologically normal tissue and during remission.
Conclusions:
- Colonic mucosal involvement in UC may be universal and persist during remission.
- Ultrastructural changes can precede light microscopic findings.
- These findings underscore the importance of maintenance therapy in ulcerative colitis.