Demonstration of tissue and peripheral blood eosinophils in patients with acute appendicitis

Authors

  • Shahla J. Hussein Department of Biology, Faculty of Science and Health, Koya University, koya KOY45, Kurdistan Region-F.R. Iraq
  • Sarmad Raheem Kareem Faculty of Medicine, Koya University, koya KOY45, Kurdistan Region-F.R. Iraq

DOI:

https://doi.org/10.21271/ZJPAS.35.6.12

Keywords:

Acute Appendicitis (AA), Acute Eosinophil Appendicitis (AEA), histopathological and Congo red.

Abstract

    Acute appendicitis (AA) is the most surgical emergencies. Clinical diagnosis is usually confirmed by adjuvant laboratory testing but histopathology is the gold standard for diagnosis. Acute eosinophilic appendicitis (AEA) is a rare form of appendicitis with muscularis propria infiltration and muscle fiber edema. This study was aimed to find simple and accurate way for the diagnosis of unusual eosinophilic appendicitis that may requires postoperative special treatment. A prospective investigation was conducted at Shahid Dr. Khalid Teaching Hospital in (Koya city/ Kurdistan Region/ Iraq), This involves randomly selecting fifty appendectomy samples from emergency department patients from November 2021 to May 2022. Acute appendicitis is suspected in these patients based on their medical history, physical examination, investigation, and abdominal ultrasound. The patients were 28 (56% males) and 22 (44% females). Patients ranged in age from 4 to 43 years, with a mean of 20.98 years, and The majority of cases (60%) are under 20. A significant gradual (increase in weight and decrease in dimensions) of appendix with different age group was seen. Theoretical and actual means of CBC parameters differed significantly, although there was no significant sex difference. Tissue and peripheral blood eosinophil counts were directly correlated (P < 0.01), although there was a negative correlation between tissue and WBC count (P<0.0019). Congo red was statistically highly significant (P< 0.0001) in detecting tissue eosinophils compared to MGG and H&E. In conclusion, Congo red better than H&E and MGG staining for identifying tissue eosinophils, also tissue and peripheral blood eosinophils were positively correlated.

References

ABDEL-LATIF, M., HAFREL-BATIN, E., SHAHIN, R., SHAWQY, A., ARAFA, M. & GHAFAR SALEH, A. A. 2016. Value of Additional Corpus Biopsy for Diagnosis of Helicobacter Pylori in Atrophic Gastritis. Clin Surg, 1, 1093.

AGGELIDOU, M., KAMBOURI, K., KOUROUPI, M., CASSIMOS, D., FOUTZITZI, S. & DEFTEREOS, S. 2019. Acute eosinophilic appendicitis after generalized skin reaction due to unknown cause in a child: Case report and literature review. Clinics and practice, 9, 1177.

AHMED, S., JHA, A., ALI, F. M., GHAREEB, A. E., GARG, D. & JHA, M. 2019. Sensitivity and Specificity of the Neutrophil-lymphocyte Ratio in the Diagnosis of Acute Appendicitis. Annals of Clinical & Laboratory Science, 49, 632-638.

AKBULUT, S., KOC, C., KOCAASLAN, H., GONULTAS, F., SAMDANCI, E., YOLOGLU, S. & YILMAZ, S. 2019. Comparison of clinical and histopathological features of patients who underwent incidental or emergency appendectomy. World Journal of Gastrointestinal Surgery, 11, 19.

AKBULUT, S., TAS, M., SOGUTCU, N., ARIKANOGLU, Z., BASBUG, M., ULKU, A., SEMUR, H. & YAGMUR, Y. 2011. Unusual histopathological findings in appendectomy specimens: a retrospective analysis and literature review. World journal of gastroenterology: WJG, 17, 1961.

AL-JAWDAH, K. & KAMAL, Z. 2022. Complete Blood Count Parameters in The Diagnosis of Acute Appendicitis. Journal of Pharmaceutical Negative Results¦ Volume, 13, 205.

AL-MULHIM, A. S. 2011. Unusual findings in appendicectomy specimens: Local experience in Al-Ahsa region of Saudi Arabia. Age, 10, 10-9.

ANAND, S., KRISHNAN, N., JUKIĆ, M., KRIŽANAC, Z., LLORENTE MUÑOZ, C. M. & POGORELIĆ, Z. 2022. Utility of red cell distribution width (RDW) as a noninvasive biomarker for the diagnosis of acute appendicitis: A systematic review and meta-analysis of 5222 cases. Diagnostics, 12, 1011.

ANDERSSON, R. E. 2007. The natural history and traditional management of appendicitis revisited: spontaneous resolution and predominance of prehospital perforations imply that a correct diagnosis is more important than an early diagnosis. World journal of surgery, 31, 86-92.

BHARTI, J. P., OMAR, S. & PANDEY, N. K. 2016. Morphological and Histological Study on Vermiform Appendix in Rabbit, Goat and Human Being.

CARVALHO, N., CAROLINO, E., COELHO, H., CÓIAS, A., TRINDADE, M., VAZ, J., CISMASIU, B., MOITA, C., MOITA, L. & COSTA, P. M. 2022. IL-5 Serum and Appendicular Lavage Fluid Concentrations Correlate with Eosinophilic Infiltration in the Appendicular Wall Supporting a Role for a Hypersensitivity Type I Reaction in Acute Appendicitis. International Journal of Molecular Sciences, 23, 15086.

DANISH, A. 2022. A retrospective case series study for acute abdomen in general surgery ward of Aliabad Teaching Hospital. Annals of Medicine and Surgery, 73, 103199.

DEBTA, P., DEBTA, F. M., CHAUDHARY, M. & DANI, A. 2012. Evaluation of infiltration of immunological cells (tumour associated tissue eosinophils and mast cells) in oral squamous cell carcinoma by using special stains. British Journal of Medicine and Medical Research, 2, 75.

DEBTA, P., DEBTA, F. M., CHAUDHARY, M. & WADHWAN, V. 2010. Evaluation of infiltration of immunological cells (tissue eosinophil and mast cell) in odontogenic cysts by using special stains. J Clin Cell Immunol, 1, 103.

DESHMUKH, S., VERDE, F., JOHNSON, P. T., FISHMAN, E. K. & MACURA, K. J. 2014. Anatomical variants and pathologies of the vermix. Emergency radiology, 21, 543-552.

DIXON, F. & SINGH, A. 2020. Acute appendicitis. Surgery (Oxford), 38, 310-317.

DOOKI, M. E., NEZHADAN, M., MEHRABANI, S., OSIA, S., HADIPOOR, A., HAJIAHMADI, M. & MOHAMMADI, M. 2022. Diagnostic accuracy of laboratory markers for diagnosis of acute appendicitis in children. Wiener Medizinische Wochenschrift, 172, 303-307.

FAISAL, L., AJMAL, R., REHMAN, F., UL ISLAM, Z., QAYYUM, S. A. & ATHAR, S. 2022. Anatomical Variations of Vermiform Appendix on Plain MDCT and Its Association with Acute Appendicitis in Adult Urban Population of Karachi, A Tertiary Care Hospital Experience. Journal of Bahria University Medical and Dental College, 12, 77-82.

GARZA-SERNA, U., RAMOS-MAYO, A., LOPEZ-GARNICA, D., LOPEZ-MORALES, J., DIAZ-ELIZONDO, J. & FLORES-VILLALBA, E. 2016. Eosinophilic acute appendicitis and intra-abdominal granuloma caused by Enterobius vermicularis in a pediatric patient. Surgical Infections Case Reports, 1, 103-105.

GHORBANI, A., FOROUZESH, M. & KAZEMIFAR, A. M. 2014. Variation in anatomical position of vermiform appendix among iranian population: an old issue which has not lost its importance. Anatomy research international, 2014.

HAGHI, A. R., POURMOHAMMAD, P. & RABIEE, M. A. S. 2020. Accuracy of mean platelet volume (MPV) and red cell distribution width (RDW) for the diagnosis of acute appendicitis: Evaluation of possible new biomarkers. Advanced Journal of Emergency Medicine, 4.

IKEDA, M., ARAKAWA, S., KOBAYASHI, T., INADA, K.-I., KIRIYAMA, Y., SAKUMA, T., IMAEDA, Y., ISHIHARA, T., MIYOSHI, H. & YAMAMOTO, S. 2022. New histopathological evaluation method for eosinophilic gastrointestinal disorders using Giemsa and direct fast scarlet stains.

IQBAL, J., SAYANI, R., TAHIR, M. & MUSTAHSAN, S. M. 2018. Diagnostic efficiency of multidetector computed tomography in the evaluation of clinically equivocal cases of acute appendicitis with surgical correlation. Cureus, 10.

IQBAL, T., AMANULLAH, A. & NAWAZ, R. 2012. Pattern and positions of vermiform appendix in people of Bannu district. Gomal Journal of Medical Sciences, 10.

IURII, B., VAHTANG, G. & ALIN, B. 2018. Acute appendicitis. The Moldovan Medical Journal, 61, 28-37.

JAIN, M., KASETTY, S., SUDHEENDRA, U. S., TIJARE, M., KHAN, S. & DESAI, A. 2014. Assessment of tissue eosinophilia as a prognosticator in oral epithelial dysplasia and oral squamous cell carcinoma—an image analysis study. Pathology Research International, 2014.

JOSHI, P. S. & KAIJKAR, M. S. 2013. A histochemical study of tissue eosinophilia in oral squamous cell carcinoma using Congo red staining. Dental Research Journal, 10, 784.

JUNG, S. K., RHEE, D. Y., LEE, W. J., WOO, S. H., SEOL, S. H., KIM, D. H. & CHOI, S. P. 2017. Neutrophil-to-lymphocyte count ratio is associated with perforated appendicitis in elderly patients of emergency department. Aging clinical and experimental research, 29, 529-536.

KINOSHITA, Y., OOUCHI, S. & FUJISAWA, T. 2019. Eosinophilic gastrointestinal diseases-Pathogenesis, diagnosis, and treatment. Allergology International, 68, 420-429.

KOLUR, A., PATIL, A. M., AGARWAL, V., YENDIGIRI, S. & SAJJANAR, B. B. 2014. The significance of mast cells and eosinophils counts in surgically resected appendix. Journal of interdisciplinary Histopathology, 2, 150-153.

LEE, J. Y. & KIM, N. 2015. Diagnosis of Helicobacter pylori by invasive test: histology. Annals of translational medicine, 3.

LIN, J., ZHANG, P., LI, Y., ZHENG, J., ZHONG, X., ZHANG, W., NIE, L. & ZHANG, B. 2005. The comparison of HE staining and giemsa staining in detection of eosinophilic granulocytes in conjunctiva scroping. Yan ke xue bao= Eye science, 21, 79-81.

MEMON, Z. A., IRFAN, S., FATIMA, K., IQBAL, M. S. & SAMI, W. 2013. Acute appendicitis: diagnostic accuracy of Alvarado scoring system. Asian journal of surgery, 36, 144-149.

MEYERHOLZ, D. K., GRIFFIN, M. A., CASTILOW, E. M. & VARGA, S. M. 2009. Comparison of histochemical methods for murine eosinophil detection in an RSV vaccine-enhanced inflammation model. Toxicologic pathology, 37, 249-255.

MOHAMMADI, S., HEDJAZI, A., SAJJADIAN, M., RAHMANI, M., MOHAMMADI, M. & MOGHADAM, M. D. 2017. Morphological variations of the vermiform appendix in Iranian cadavers: a study from developing countries. Folia morphologica, 76, 695-701.

MORIS, D., PAULSON, E. K. & PAPPAS, T. N. 2021. Diagnosis and management of acute appendicitis in adults: a review. JAMA, 326, 2299-2311.

O.AHMED, H. 2006. role of ultrasound in diagnosis of acute appendicitis. Journal of Zankoy Sulaimani, 9, 107-114.

OGUNTOLA, A. S., ADEOTI, M. L. & OYEMOLADE, T. A. 2010. Appendicitis: Trends in incidence, age, sex, and seasonal variations in South-Western Nigeria. Annals of African medicine, 9.

OHENE-YEBOAH, M. & ABANTANGA, F. A. 2009. Incidence of acute appendicitis in Kumasi, Ghana. West African journal of medicine, 28.

PATEL, S. & NAIK, A. 2016. Study of the length of vermiform appendix. Indian Journal of Basic and Applied Medical Research, 5, 256-260.

PAUL, U. K., NAUSHABA, H., ALAM, M. J., BEGUM, T., RAHMAN, A. & AKHTER, J. 2011. Length of vermiform appendix: a postmortem study. Bangladesh Journal of Anatomy, 9, 10-12.

PAWLINA, W. & ROSS, M. H. 2018. Histology: a text and atlas: with correlated cell and molecular biology, Lippincott Williams & Wilkins.

PODANY, A. B., TSAI, A. Y. & DILLON, P. W. 2017. Acute appendicitis in pediatric patients: an updated narrative review. J Clin Gastroenterol Treat, 3, 042.

RAHMAN, M. M., KHALIL, M., KHALIL, M., JAHAN, M. K., SHAFIQUAZZAMAN, M. & PARVIN, B. 2008. Mass of the Vermiform Appendix in Bangladeshi People. Journal of Bangladesh Society of Physiologist, 3, 8-12.

SALIH, M., MEHDI, A. J. & ABDULLAH, S. 2020. Human Vermiform Appendix Of Different Age Groups. Egyptian Academic Journal of Biological Sciences, D. Histology & Histochemistry, 12, 15-20.

SAMOSZUK, M. 1997. Eosinophils and human cancer. Histology and histopathology.

SARTELLI, M., BAIOCCHI, G. L., DI SAVERIO, S., FERRARA, F., LABRICCIOSA, F. M., ANSALONI, L., COCCOLINI, F., VIJAYAN, D., ABBAS, A. & ABONGWA, H. K. 2018. Prospective observational study on acute appendicitis worldwide (POSAW). World Journal of Emergency Surgery, 13, 1-10.

SAZHIN, A. V., PETUKHOV, V. A., NECHAY, T. V., IVAKHOV, G. B., STRADYMOV, E. A. & AKPEROV, A. I. 2021. Microbiological and immunological aspects of pathogenesis of acute appendicitis. Novosti khirurgii, 29, 221-223.

SCHUMPELICK, V., DREUW, B., OPHOFF, K. & PRESCHER, A. 2000. Appendix and cecum: embryology, anatomy, and surgical applications. Surgical Clinics, 80, 295-318.

SEARLE, A. R., ISMAIL, K. A., MACGREGOR, D. & HUTSON, J. M. 2013. Changes in the length and diameter of the normal appendix throughout childhood. Journal of pediatric surgery, 48, 1535-1539.

SHAHMORADI, M. K., ZAREI, F., BEIRANVAND, M. & HOSSEINNIA, Z. 2021. A retrospective descriptive study based on etiology of appendicitis among patients undergoing appendectomy. International Journal of Surgery Open, 31, 100326.

SNYDER, M. J., GUTHRIE, M. & CAGLE JR, S. D. 2018. Acute appendicitis: efficient diagnosis and management. American family physician, 98, 25-33.

SONG, Y., YIN, J., CHANG, H., ZHOU, Q., PENG, H., JI, W. & SONG, Q. 2018. Comparison of four staining methods for detecting eosinophils in nasal polyps. Scientific reports, 8, 17718.

SUJATHA, R., SHAFIUDDIN, R., KULKARNI, M. V. & MANJUNATHA, Y. 2022. Tumour Associated Tissue Eosinophilia in Oral Squamous Cell Carcinoma by Special Histochemical Analysis of Tissue Eosinophilia using Congo Red Staining.

TANRIKULU, C. S., TANRIKULU, Y., SABUNCUOGLU, M. Z., KARAMERCAN, M. A., AKKAPULU, N. & COSKUN, F. 2014. Mean platelet volume and red cell distribution width as a diagnostic marker in acute appendicitis. Iranian Red Crescent Medical Journal, 16.

TARTAR, T., BAKAL, Ü., SARAÇ, M., AYDIN, S. & KAZEZ, A. 2020. Diagnostic value of laboratory results in children with acute appendicitis. Turkish Journal of Biochemistry, 45, 553-558.

TÉOULE, P., DE LAFFOLIE, J., ROLLE, U. & REISSFELDER, C. 2020. Acute appendicitis in childhood and adulthood: an everyday clinical challenge. Deutsches Ärzteblatt international, 117, 764.

TULLAVARDHANA, T., SANGUANLOSIT, S. & CHARTKITCHAREON, A. 2021. Role of platelet indices as a biomarker for the diagnosis of acute appendicitis and as a predictor of complicated appendicitis: A meta-analysis. Annals of Medicine and Surgery, 66, 102448.

ULUKENT, S. C., SARICI, I. S. & ULUTAS, K. T. 2016. All CBC parameters in diagnosis of acute appendicitis. Int J Clin Exp Med, 9, 11871-11876.

WILLIAMS, N. S., BULSTRODE, C. J. K. & O’CONNELL, P. R. 2008. Short practice of surgery. Bailey and Love.

Published

2023-12-15

How to Cite

Shahla J. Hussein, & Sarmad Raheem Kareem. (2023). Demonstration of tissue and peripheral blood eosinophils in patients with acute appendicitis. Zanco Journal of Pure and Applied Sciences, 35(6), 118–130. https://doi.org/10.21271/ZJPAS.35.6.12

Issue

Section

Biology, Chemistry and Medical Researches