Role of macrophage microaggregation in the diagnosis of inflammatory colitis

Abstract

Aim: Recent studies have advocated that the presence of macrophage microaggregations (MMA) may be a criterion in the diagnosis of Crohn's colitis (CC). In our study we aimed to investigate the role of MMA to differenti-ate ulcerative colitis (UC) and (CC). Material and Method: We analyzed the role of MMA in 29 patients with UC, 26 patients with CC and 22 healthy subjects without diagnosis of inflammatory bowel disease. For all subjects, esophagogastroduodenoscopy was performed. Biopsies were taken from non-lesion regions of stomach and duodenum. Biopsy materials underwent immunohistochemical staining for the microscopic investigation of the presence of MMA. Also, determination of Perinuclear Anti-Neutropil Cytoplasmic Antibodies (pANCA) and Anti-Saccharomyces Cerevisiae Antibodies (ASCA) (Immunoglobulin G and A) was done with ELISA in serum samples. In patient and control groups, presence of Helicobacter pylori (H. pylori) positivity was histopathologically evaluated. Results: MMA was higher in patients with both CC and UC compared with control groups (46.2%, 41.3%, and 9.1% respec-tively). There was statistically significant difference between patient groups and the control group in terms of MMA but there was no difference between CC and UC groups (p=0.007). No statistically significant difference was ob-tained between the groups in terms of ASCA and p-ANCA. H.pylori positivity was determined in 41.3% of MMA patients with CC, in 75% of patients with UC, and in 50% of healthy subjects. There was no significant difference between the three groups (p=0.344). Discussion: MMA positivity increases in patients with both CC and UC. In patients with inflammatory colitis, H. pylori existence, pANCA and ASCA positivity was similar to healthy subjects.