Mast cells in the GI tract: How many is too many? (Part Four)

The 2012 study by Akhavein that described allergic mastocytic enterocolitis also performed biopsies on the stomach of patients with a history of atopic/allergic disease were biopsied.  Mast cells were identified using an antibody to CD117, the CKIT receptor found on the surface of all mast cells. The cells were counted in only 1 hpf.  On average, there were 39 mast cells/hpf with a range of 16-82 mast cells/hpf.  These cells were also scattered and not clustered.  See Table 13 for details.

Table 13: Mast cell count in stomach of patients with GI pain and dysmotility and a history of allergic disease
Akhavein AM, et al. Allergic mastocytic gastroenteritis and colitis: An unexplained etiology in chronic abdominal pain and gastrointestinal dysmotility. Gastroenterology Research and Practice (2012): Article ID 950582.
Stomach Study group: atopic/allergic history with abdominal pain and GI dysmotility Control group A:

No control group

Control group B:

No control group

Average Range Average Range Average Range
39 mast cells/hpf 16-82 mast cells/hpf N/A N/A N/A N/A
Diffuse, scattered cells, no clusters.

 

A 2015 publication evaluated the mast cell count in patients with chronic diarrhea for unknown reasons.  Mast cells were quantified using an antibody to CD117.  Cells were only counted in 1 hpf in the portion of the slide with the most mast cells.  The healthy control group averaged 24 mast cells/hpf, while the study group with chronic diarrhea averaged 31 mast cells/hpf. See Table 14 for details.

Table 14: Mast cell count in colon of patients with chronic diarrhea
Sethi A, et al. Performing colonic mast cell counts in patients with chronic diarrhea of unknown etiology has limited diagnostic use. Arch Pathol Lab Med 2015; 139 (2): 225-232.
Microscopy method: 400x magnification, mast cells counted in 1 hpf
Visualization: CD117 and tryptase (IHC)
Sample type Study group: Chronic diarrhea Control group A:

Healthy controls

Control group B:

No control group

Colon Average Range Average Range Average Range
31 mast cells/hpf 24-34 mast cells/hpf 24 mast cells/hpf 22-27 mast cells/hpf N/A N/A
Diffuse scattered cells, no clusters. Diffuse scattered cells, no clusters.

 

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Akhavein AM, et al. Allergic mastocytic gastroenteritis and colitis: An unexplained etiology in chronic abdominal pain and gastrointestinal dysmotility. Gastroenterology Research and Practice (2012): Article ID 950582.

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Sethi A, et al. Performing colonic mast cell counts in patients with chronic diarrhea of unknown etiology has limited diagnostic use. Arch Pathol Lab Med 2015; 139 (2): 225-232.

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Minnei F, et al. Chronic urticaria is associated with mast cell infiltration in the gastroduodenal mucosa. Virchows Arch 2006; 448(3): 262-8.

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Barbara G, et al. Activated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome. Gastroenterology 2004; 126(3): 693-702.

Guilarte M, et al. Diarrhoea-predominant IBS patients show mast cell activation and hyperplasia in the jejunum. Gut 2007; 56: 203-209.

Dunlop SP, et al.  Age related decline in rectal mucosal lymphocytes and mast cells. European Journal of Gastroenterology and Hepatology 2004; 16(10): 1011-1015.

Afrin LB, Molderings GJ. A concise, practical guide to diagnostic assessment for mast cell activation disease. World J Hematol 2014; 3 (1): 1-17.

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Valent P, et al. Definitions, criteria and global classification of mast cell disorders with special reference to mast cell activation syndromes: a consensus proposal. Int Arch Allergy Immunol 2012: 157 (3): 215-225.