Abstract
Immunohistochemistry application as step one for diagnosing human intestinal spirochetosis
Highlights
Human intestinal spirochetosis (HIS) is caused by colonization by Brachyspira species bacteria within the human large intestine [1,2]
Diagnostic pathologists finding characteristic, but subtle, so-called fringes -- band-like structures caused by a perpendicular arrangement of the bacteria -- on the colorectal surface mucosa on hematoxylin & eosin (HE) sections usually raise a suspicion of HIS
The remaining two HIS-IHC cases did not match either of the equivocal HIS-HE cases, and they were overlooked in HE pathology
Summary
Human intestinal spirochetosis (HIS) is caused by colonization by Brachyspira species bacteria within the human large intestine [1,2]. Diagnostic pathologists finding characteristic, but subtle, so-called fringes -- band-like structures caused by a perpendicular arrangement of the bacteria -- on the colorectal surface mucosa on hematoxylin & eosin (HE) sections usually raise a suspicion of HIS. Ancillary stainings such as Giemsa, Gram, and Warthin-Starry stains may be added to confirm the diagnosis [1]. Immunohistochemistry (IHC) with commercially available antibodies to Treponema pallidum (TP), another type of Spirochete, has been reported to exhibit IHC cross-reaction with these fringes, and pathologic diagnosis of HIS has been performed on the basis of a finding of the fringe formation in routine histology, sometimes supported by this IHC confirmation [3,4]. To elucidate whether an initial IHC application might increase the proportion of HIS cases, we compared diagnostic utility between HE (HIS-HE; focusing on the so-called fringes) and IHC (HIS-IHC; using a polyclonal anti-TP antibody)
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