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Evaluation of mucosal mast cell density in pediatric eosinophilic gastroenteritis

BackgroundPrimary eosinophilic gastrointestinal diseases include a spectrum of conditions in which an increased collection of eosinophils occurs within the gastrointestinal tract in the setting of symptomatic gastrointestinal disease. Diseases falling under this broad category include eosinophilic esophagitis, eosinophilic gastroenteritis (EG), and eosinophilic colitis. Increased numbers of mast cells have been described in pediatric and adult patients with eosinophilic esophagitis, but the knowledge of these cells in other eosinophilic gastrointestinal diseases conditions is still limited. ObjectiveThe aim of the present study was to evaluate the density and activation of mucosal mast cells in EG in a group of Egyptian children and to correlate the findings with abnormal eosinophilic infiltration in a trial to clarify the possible role of mast cells in pediatric EG. Materials and methodsTissue samples from 45 pediatric cases diagnosed with EG were submitted for immunohistochemical staining with mast cell tryptase antibody and the mean counts of mucosal mast cells were assessed semiquantitatively. ResultsThe mucosal mast cell density scores were + (17.8%) with a mean mast cell count of 15.8±3.41, ++ (62.2%) with a mean count of 27.9±5.24, and +++ (20%) with a mean count of 47.6±7.24. Mast cell degranulation was found in 88.9% of the studied cases. A statistically significant relation was found between mucosal eosinophilic infiltration and mast cell density (P=0.045). There was also a significant relation between mucosal eosinophilic infiltration and the degree of mast cell degranulation (P=0.026). ConclusionOur findings suggest that mast cells may play a possible role in pediatric EG as demonstrated by their increased density, activation, and their significant correlation with mucosal eosinophilic infiltration.