Histopathologic diagnosis of celiac disease in children without clinical evidence of malabsorption

Clinical and pathologic features of nodular duodenum: An analysis of 17 cases

AIM: To investigate the incidence, clinical presentations, histopathological features, natural history, and response to therapy of nodular duodenum.

METHODS: The clinical data for 17 patients with nodular duodenum were analyzed retrospectively, including age, sex, disease type, symptoms, final diagnosis, histopathology, hemoglobin, SF, AL, IG, and OVA.

RESULTS: Of 17 patients with nodular duodenum, 9 were male and 8 were female. Their mean age was 28.1 years. Approximately 47% of patients had stomachache. Sinus tubercle was most frequently seen endoscopically. Histology of duodenal nodules revealed chronic inflammation in all cases, intraepithelial eosinophilic granulocyte proliferation in 70.5% of cases, and villous atrophy in 47% of cases. Six patients had flagellate. Clinical diagnostic features included diarrhea, giardiasis, secretory IgA deficiency, and Helicobacter pylori-associated gastritis.

CONCLUSION: Nodular duodenum is an endoscopically distinct entity that may respond clinically to antisecretory therapy but is difficult to eradicate.

Decreased cortical muscarinic receptors define a subgroup of subjects with schizophrenia

Schizophrenia is widely acknowledged as being a syndrome, consisting of an undefined number of diseases probably with differing pathologies. Although studying a syndrome makes the identification of an underlying pathology more difficult; neuroimaging, neuropsychopharmacological and post-mortem brain studies all implicate muscarinic acetylcholine receptors (CHRM) in the pathology of the disorder. We have established that the CHRM1 is selectively decreased in the dorsolateral prefrontal cortex of subjects with schizophrenia. To expand this finding, we wanted to ascertain whether decreased cortical CHRMs might (1) define a subgroup of schizophrenia and/or (2) be related to CHRM1 genotype. We assessed cortical [(3)H]pirenzepine binding and sequenced the CHRM1 in 80 subjects with schizophrenia and 74 age sex-matched control subjects. Kernel density estimation showed that [(3)H]pirenzepine binding in BA9 divided the schizophrenia, but not control, cohort into two distinct populations. One of the schizophrenia cohorts, comprising 26% of all subjects with the disorder, had a 74% reduction in mean cortical [(3)H]pirenzepine binding compared to controls. We suggest that these individuals make up 'muscarinic receptor-deficit schizophrenia' (MRDS). The MRDS could not be separated from other subjects with schizophrenia by CHRM1 sequence, gender, age, suicide, duration of illness or any particular drug treatment. Being able to define a subgroup within schizophrenia using a central biological parameter is a pivotal step towards understanding the biochemistry underlying at least one form of the disorder and may represent a biomarker that can be used in neuroimaging.