Evaluation of the inflammatory infiltrate in pouchitis with 111In-labeled granulocytes.

Abstract

BACKGROUND:

The aim of this study was to elucidate the inflammatory infiltrate in pouchitis and define the changes following metronidazole therapy.

METHODS:

Twenty-seven patients underwent functional grading, sigmoidoscopic and histological scoring, 111In-labeled granulocyte scanning, and 4-day fecal collections for 111In-labeled granulocyte excretion. Six of the patients with pouchitis underwent repeat studies after 1-month treatment with metronidazole, 400 mg three times daily.

RESULTS:

The grade of macroscopic inflammation in the pouch mucosa (sigmoidoscopic score) correlated well with the acute histological score (P < 0.0001), chronic histological score (P < 0.001), 4-hour 111In scan (P < 0.001), 24-hour 111In scan (P < 0.001), and with 4-day fecal 111In excretion (P < 0.001). After metronidazole therapy there was decreased inflammatory grade sigmoidoscopically and histologically on the 4- and 24-hour scans and decreased 4-day fecal 111In granulocyte excretion.

CONCLUSIONS:

This study confirms that the inflammatory infiltrate in pouchitis is acute or chronic, is characterized by neutrophils, is usually localized to pouch mucosa, and is always decreased after metronidazole therapy.

• Authors: W A Kmiot, S R Hesslewood, N Smith, H Thompson, L K Harding, M R Keighley
• Journal: Gastroenterology (Gastroenterology) Vol. 104 Issue 4 Pg. 981-8 (Apr 1993) ISSN: 0016-5085 [Print] United States
• PMID: 8462824 (Publication Type: Journal Article)

Chemical References

• Indium Radioisotopes
• Metronidazole

Topics

• Acute Disease
• Biopsy
• Chronic Disease
• Gastrointestinal Hemorrhage (etiology, pathology)
• Granulocytes (pathology, physiology)
• Humans
• Indium Radioisotopes
• Inflammation (drug therapy, physiopathology)
• Intestinal Mucosa (pathology)
• Metronidazole (therapeutic use)
• Proctocolectomy, Restorative (adverse effects)
• Sigmoidoscopy