Chronic Granulomatous Disease and Crohn's Disease Histopathological Distinctive Features: A Pediatric Study

Abstract

AIM: To identify potential distinctive histopathological features of the gastrointestinal mucosa involvement in children with Crohn’s Disease (CD) and Chronic Granulomatous Disease (CGD). METHODS: Comparative evaluation of mucosal gastrointestinal involvement in 4 children with CG and CD (n=8). The evaluation included Periodic Acid Schiff (PAS) and Immunohistochemical staining for CD68 in colonic biopsies. RESULTS: Endoscopy was performed at a mean age of 5.5 years and 9.1 years at CDG and CD patients, respectively. Findings were similar in both groups. Histologically, in the colon, CGD patients showed focal architectural distortion (n=2), patchy mono/polymorphonuclear infiltrate (n=4), focal cryptitis (n=3) and noncaseating granulomas (n=3); patients with CD presented focal architectural distortion (n=4), patchy inflammatory mono/polymorphonuclear infiltrate (n=4), cryptitis (n=4), crypt abscesses (n=3), ulceration (n=3) and noncaseating granulomas (n=3). PAS positive pigmented histiocytes in the lamina propria were observed in all CGD patients and absent in CD. In CGD patients, CD68 positive cells with vast cytoplasm were found, mostly at a deep location in the lamina propria, and in clusters. In CD, CD68 positive cells featured a distinct pattern, with less cytoplasm and appeared predominantly isolated and scattered. CONCLUSION: Although our results are preliminary, they suggest that the characterization of histiocyte infiltrate and of its topographic pattern, using additionally valuable markers as PAS and CD68 immunostaining, may further contribute to better discriminate CGD and CD.