Esofagite de refluxo em crianças: estudo histológico e morfométrico

Detalhes bibliográficos
Autor(a) principal: Mader, Ana Maria Amaral Antonio [UNIFESP]
Data de Publicação: 2002
Outros Autores: Alves, Maria Teresa de Seixas [UNIFESP], Kawakami, Elisabete [UNIFESP], Patricio, Francy Reis da Silva [UNIFESP]
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: http://dx.doi.org/10.1590/S0004-28032002000200011
http://repositorio.unifesp.br/handle/11600/1404
Resumo: Background - Gastroesophageal reflux disease is a frequent cause of morbidity in childhood, including esophagitis and recurrent respiratory symptoms; however histological and morphometric studies in esophageal biopsies of children are scarce. Aim - To study histological and morphometric findings in children with reflux esophagitis. Patients and Methods - We studied 26 esophageal biopsies of children (mean age: 4.1 years ± 3.4) with reflux esophagitis, which prevailed in boys (84.6%); post-prandial vomiting (76.9%) and repetitive bronchopneumonia (38.5%) were the most frequent symptoms. The diagnosis was made by X-ray in 18, by pH evaluation in 5 and by scintilography in 3 patients. The control group was formed by seven children without reflux symptoms who died from meningococcemia or congenital heart malformation (mean age: 2.5 years ± 2.3). Histological variables were studied by hematoxylin-eosin and periodic acid of Schiff stain, inflammatory infiltrate, epithelial and basal layer thickness, papillary length and its ratio with the thickness of the epithelium. Morphometry was performed at a digital system connected to pro-image software. Student's t test, Mann-Whitney test, Fisher and Pearson's correlation methods were used for the statistical analysis. Results - Epithelial and basal zone thickness, papillary length and its rate with thickness of epithelium, among the reflux group patients were higher than the control group. Eosinophils, neutrophils and balloon cells were not observed in the control group. Intraepithelial capillaries occurred in 11 cases in the reflux group (mean diameter: 59 mum). Conclusion - Epithelial and basal zone thickness, papillary length and its ratio with thickness of epithelium, resulted greater in the gastroesophageal reflux group than in the control group. There was a direct correlation between thickness of epithelium, basal zone thickness and papillary length, showing increased epithelial cell turnover. Eosinophils, neutrophils and balloon cells were observed only in patients with gastroesophageal reflux, thus serving as specific markers of this disease.
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spelling Esofagite de refluxo em crianças: estudo histológico e morfométricoReflux esophagitis in children: histological and morphometric studyEsophagitis, pepticEsophagusChildEsofagite pépticaEsôfagoCriançaBackground - Gastroesophageal reflux disease is a frequent cause of morbidity in childhood, including esophagitis and recurrent respiratory symptoms; however histological and morphometric studies in esophageal biopsies of children are scarce. Aim - To study histological and morphometric findings in children with reflux esophagitis. Patients and Methods - We studied 26 esophageal biopsies of children (mean age: 4.1 years ± 3.4) with reflux esophagitis, which prevailed in boys (84.6%); post-prandial vomiting (76.9%) and repetitive bronchopneumonia (38.5%) were the most frequent symptoms. The diagnosis was made by X-ray in 18, by pH evaluation in 5 and by scintilography in 3 patients. The control group was formed by seven children without reflux symptoms who died from meningococcemia or congenital heart malformation (mean age: 2.5 years ± 2.3). Histological variables were studied by hematoxylin-eosin and periodic acid of Schiff stain, inflammatory infiltrate, epithelial and basal layer thickness, papillary length and its ratio with the thickness of the epithelium. Morphometry was performed at a digital system connected to pro-image software. Student's t test, Mann-Whitney test, Fisher and Pearson's correlation methods were used for the statistical analysis. Results - Epithelial and basal zone thickness, papillary length and its rate with thickness of epithelium, among the reflux group patients were higher than the control group. Eosinophils, neutrophils and balloon cells were not observed in the control group. Intraepithelial capillaries occurred in 11 cases in the reflux group (mean diameter: 59 mum). Conclusion - Epithelial and basal zone thickness, papillary length and its ratio with thickness of epithelium, resulted greater in the gastroesophageal reflux group than in the control group. There was a direct correlation between thickness of epithelium, basal zone thickness and papillary length, showing increased epithelial cell turnover. Eosinophils, neutrophils and balloon cells were observed only in patients with gastroesophageal reflux, thus serving as specific markers of this disease.Racional - Refluxo gastroesofágico é afecção relativamente comum na infância e pode causar morbidade, havendo porém poucos estudos histológicos e morfométricos em biopsias esofágicas de crianças. Objetivo - Estudar aspectos histológicos e morfométricos da esofagite de refluxo em crianças. Material e Métodos - Foram analisadas 26 biopsias esofágicas (média de idade de 4,1 ± 3,4 anos), com diagnóstico histológico prévio de esofagite de refluxo. Refluxo gastroesofágico também foi confirmado pela radiologia em 18, pHmetria em 5 e cintilografia em 3 pacientes. O sexo masculino predominou (84,6%); vômitos pós-prandiais (76,9%) e broncopneumonia de repetição foram os sintomas mais freqüentes. O grupo controle constou de sete crianças assintomáticas para refluxo gastroesofágico, cuja causa da morte foi meningococcemia (quatro casos) e cardiopatia congênita (três casos) (média de idade de 2,5 ± 2,3 anos). Utilizaram-se as técnicas histoquímicas hematoxilina-eosina e ácido periódico de Schiff para avaliar infiltrado inflamatório, espessura do epitélio, da camada basal e o comprimento papilar. A morfometria foi feita por meio de sistema digital conectado ao software Pro-Image. Para análise estatística utilizou-se o teste t de Student, teste de Mann-Whitney, exato de Fisher e coeficiente de correlação de Pearson. Resultados - Espessura epitelial e da camada basal, comprimento papilar absoluto e relativo foram significativamente maiores no grupo de crianças com esofagite em relação ao grupo controle. Eosinófilos, neutrófilos e balloon cells não foram observados no grupo controle. Capilares intra-epiteliais foram observados em 11 casos de esofagite de refluxo (diâmetro médio de 59 mim), estando ausentes no grupo controle. Conclusão - Na esofagite de refluxo houve aumento da espessura epitelial, da camada basal, do comprimento papilar (em número absoluto e relativo) em relação ao controle. Houve, ainda, correlação linear positiva entre espessura epitelial total, espessura da camada basal e comprimento papilar, denotando maior turnover das células epiteliais. Polimorfonucleares eosinófilos, neutrófilos e balloon cells estavam presentes somente em biopsias de crianças com esofagite, sendo portanto, indicadores específicos desta afecção.Fundação ABC Faculdade de Medicina Departamento de PatologiaUNIFESP-EPM Departamento de PatologiaUNIFESP-EPM Disciplina de Gastroenterologia PediátricaUNIFESP, EPM, Depto. de PatologiaUNIFESP, EPM Disciplina de Gastroenterologia PediátricaSciELOInstituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBEDFundação ABC Faculdade de Medicina Departamento de PatologiaUniversidade Federal de São Paulo (UNIFESP)Mader, Ana Maria Amaral Antonio [UNIFESP]Alves, Maria Teresa de Seixas [UNIFESP]Kawakami, Elisabete [UNIFESP]Patricio, Francy Reis da Silva [UNIFESP]2015-06-14T13:29:40Z2015-06-14T13:29:40Z2002-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion126-131application/pdfhttp://dx.doi.org/10.1590/S0004-28032002000200011Arquivos de Gastroenterologia. Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, v. 39, n. 2, p. 126-131, 2002.10.1590/S0004-28032002000200011S0004-28032002000200011.pdf0004-2803S0004-28032002000200011http://repositorio.unifesp.br/handle/11600/1404porArquivos de Gastroenterologiainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-05T16:52:11Zoai:repositorio.unifesp.br/:11600/1404Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-05T16:52:11Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Esofagite de refluxo em crianças: estudo histológico e morfométrico
Reflux esophagitis in children: histological and morphometric study
title Esofagite de refluxo em crianças: estudo histológico e morfométrico
spellingShingle Esofagite de refluxo em crianças: estudo histológico e morfométrico
Mader, Ana Maria Amaral Antonio [UNIFESP]
Esophagitis, peptic
Esophagus
Child
Esofagite péptica
Esôfago
Criança
title_short Esofagite de refluxo em crianças: estudo histológico e morfométrico
title_full Esofagite de refluxo em crianças: estudo histológico e morfométrico
title_fullStr Esofagite de refluxo em crianças: estudo histológico e morfométrico
title_full_unstemmed Esofagite de refluxo em crianças: estudo histológico e morfométrico
title_sort Esofagite de refluxo em crianças: estudo histológico e morfométrico
author Mader, Ana Maria Amaral Antonio [UNIFESP]
author_facet Mader, Ana Maria Amaral Antonio [UNIFESP]
Alves, Maria Teresa de Seixas [UNIFESP]
Kawakami, Elisabete [UNIFESP]
Patricio, Francy Reis da Silva [UNIFESP]
author_role author
author2 Alves, Maria Teresa de Seixas [UNIFESP]
Kawakami, Elisabete [UNIFESP]
Patricio, Francy Reis da Silva [UNIFESP]
author2_role author
author
author
dc.contributor.none.fl_str_mv Fundação ABC Faculdade de Medicina Departamento de Patologia
Universidade Federal de São Paulo (UNIFESP)
dc.contributor.author.fl_str_mv Mader, Ana Maria Amaral Antonio [UNIFESP]
Alves, Maria Teresa de Seixas [UNIFESP]
Kawakami, Elisabete [UNIFESP]
Patricio, Francy Reis da Silva [UNIFESP]
dc.subject.por.fl_str_mv Esophagitis, peptic
Esophagus
Child
Esofagite péptica
Esôfago
Criança
topic Esophagitis, peptic
Esophagus
Child
Esofagite péptica
Esôfago
Criança
description Background - Gastroesophageal reflux disease is a frequent cause of morbidity in childhood, including esophagitis and recurrent respiratory symptoms; however histological and morphometric studies in esophageal biopsies of children are scarce. Aim - To study histological and morphometric findings in children with reflux esophagitis. Patients and Methods - We studied 26 esophageal biopsies of children (mean age: 4.1 years ± 3.4) with reflux esophagitis, which prevailed in boys (84.6%); post-prandial vomiting (76.9%) and repetitive bronchopneumonia (38.5%) were the most frequent symptoms. The diagnosis was made by X-ray in 18, by pH evaluation in 5 and by scintilography in 3 patients. The control group was formed by seven children without reflux symptoms who died from meningococcemia or congenital heart malformation (mean age: 2.5 years ± 2.3). Histological variables were studied by hematoxylin-eosin and periodic acid of Schiff stain, inflammatory infiltrate, epithelial and basal layer thickness, papillary length and its ratio with the thickness of the epithelium. Morphometry was performed at a digital system connected to pro-image software. Student's t test, Mann-Whitney test, Fisher and Pearson's correlation methods were used for the statistical analysis. Results - Epithelial and basal zone thickness, papillary length and its rate with thickness of epithelium, among the reflux group patients were higher than the control group. Eosinophils, neutrophils and balloon cells were not observed in the control group. Intraepithelial capillaries occurred in 11 cases in the reflux group (mean diameter: 59 mum). Conclusion - Epithelial and basal zone thickness, papillary length and its ratio with thickness of epithelium, resulted greater in the gastroesophageal reflux group than in the control group. There was a direct correlation between thickness of epithelium, basal zone thickness and papillary length, showing increased epithelial cell turnover. Eosinophils, neutrophils and balloon cells were observed only in patients with gastroesophageal reflux, thus serving as specific markers of this disease.
publishDate 2002
dc.date.none.fl_str_mv 2002-04-01
2015-06-14T13:29:40Z
2015-06-14T13:29:40Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1590/S0004-28032002000200011
Arquivos de Gastroenterologia. Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, v. 39, n. 2, p. 126-131, 2002.
10.1590/S0004-28032002000200011
S0004-28032002000200011.pdf
0004-2803
S0004-28032002000200011
http://repositorio.unifesp.br/handle/11600/1404
url http://dx.doi.org/10.1590/S0004-28032002000200011
http://repositorio.unifesp.br/handle/11600/1404
identifier_str_mv Arquivos de Gastroenterologia. Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, v. 39, n. 2, p. 126-131, 2002.
10.1590/S0004-28032002000200011
S0004-28032002000200011.pdf
0004-2803
S0004-28032002000200011
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv Arquivos de Gastroenterologia
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 126-131
application/pdf
dc.publisher.none.fl_str_mv Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED
publisher.none.fl_str_mv Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
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