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[Hirschsprung's disease: the immunohistochemistry as ancillary method for the diagnosis.]
[hirschsprung disease]
Background
:
the
confirmatory
diagnosis
of
Hirschsprung
's
disease
is
made
by
histopathological
study
.
However
,
this
procedure
is
limited
with
only
hematoxylin
and
eosin
staining
,
especially
in
biopsies
of
premature
babies
or
when
non-expert
pathologists
make
the
evaluation
.
The
immunohistochemistry
from
ganglia
cell
calretinin
has
been
used
to
reduce
the
risk
of
misdiagnosis
.
Our
objective
was
to
show
the
benefits
of
this
antibody
in
diagnosis
of
Hirschsprung
's
disease
in
biopsy
specimens
.
Methods
:
we
evaluated
patients
with
histopathological
diagnosis
of
Hirschsprung
's
disease
made
by
hematoxylin
and
eosin
staining
.
We
determined
if
there
was
enough
paraffin
block
for
immunohistochemistry
with
two
markers
:
calretinin
and
neurofilaments
.
Three
controls
of
autopsy
of
children
under
3
years
of
age
with
other
diagnosis
were
included
.
Results
:
of
a
total
of
48
cases
with
histopathological
diagnosis
of
Hirschsprung
's
disease
only
13
had
adequate
tissue
for
immunohistochemistry
.
The
immunohistochemistry
confirmed
the
diagnosis
in
nine
cases
.
In
the
other
four
cases
there
were
initial
misdiagnosis
due
to
evidence
of
calretinin
(
ganglion
cells
)
and
,
thus
,
Hirschsprung
's
disease
was
discarded
.
Conclusions
:
the
use
of
immunohistochemistry
allows
confirming
the
diagnosis
of
Hirschsprung
's
disease
and
reduce
the
risk
of
a
false-
positive
result
with
only
hematoxylin
and
eosin
staining
.
Diseases
Validation
Diseases presenting
"evidence of calretinin"
symptom
hirschsprung disease
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