Abstract
Abdominal scintiscans were performed and three-day fecal indium-111 radioactivity measured, following injection of indium-111-labeled polymorphonuclear leukocytes, in patients with acute gastroenteritis, enteropathogen carriage, exacerbations of chronic inflammatory bowel disease, and patients without gastrointestinal symptoms. The colon was more commonly inflamed than the small intestine in acute gastroenteritis. Fecal indium-111 radioactivity excretion was elevated in gastroenteritis and in chronic inflammatory bowel disease. The magnitude of the intestinal inflammatory response, as measured by fecal indium-111 excretion, is equivalent in acute gastroenteritis caused by a defined enteropathogen and exacerbations of chronic inflammatory bowel disease. All patients with microscopically detected fecal leukocytosis gave positive intestinal scintiscans, whereas negative scans were obtained on patients without fecal leukocytosis. The results of this study suggest that indium-111-labeled polymorphonuclear leukocytes can be used to study pathophysiology of the enteric inflammatory response in acute infectious gastroenteritis.
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References
Lambert HP: Bacterial infections of the gastrointestinal tract. Clin Gastroenterol 8:125–133, 1979
Field M: Modes of action of enterotoxins fromVibrio cholerae andEscherichia coli. Rev Infect Dis 1:918–926, 1979
Stoll BJ, Glass RI, Huq MI, Khan MU, Banu H, Holt J: Epidemiologic and clinical features of patients who attended a diarrheal disease hospital in Bangladesh. J Infect Dis 146:177–183, 1982
Libby JM, Jortner BS, Wilkins TD: Effects of the two toxins ofClostridium difficile in antibiotic-associated cecitis in hamsters. Infect Immun 36:822–829, 1982
Saverymuttu SH, Peters AM, Croton ME, Rees H, Lavender JP, Hodgson HJF, Chadwick VS:111Indium autologous granulocytes in the detection of inflammatory bowel disease. Gut 26:955–960, 1985
Saverymuttu SH, Peters AM, Lavender JP, Pepys MB, Hodgson HJF, Chadwick VS: Quantitative indium-111-labelled leukocyte excretion in the assessment of disease in Crohn's disease. Gastroenterology 85:1333–1339, 1983
Saverymuttu SH, Peters AM, Hodgson HJF, Chadwick VS: Assessment of disease activity in ulcerative colitis using indium-111-labelled leukocyte faecal excretion. Scand J Gastroenterol 18:907–912, 1982
Korzeniowski OM, Barada FA, Rouse JD, Guerrant RL: Value of examination for fecal leukocytes in the early diagnosis of shigellosis. Am J Trop Med Hyg 28:1031–1035, 1979
Harris JC, Dupont HL, Hornick RB: Fecal leukocytes in diarrheal illness. Ann Intern Med 76:697–703, 1972
Saverymuttu SH, Hodgson HJF, Chadwick VS: Comparison of fecal granulocyte excretion in ulcerative colitis and Crohn's colitis. Dig Dis Sci 29:1000–1004, 1984
Kendall MG, Stuart A: The Advanced Theory of Statistics, Vol. 3. Charles Griffin, London, 1968, p 45
Kumar NB, Nostrant TT, Appelman HD: The histopathologic spectrum of acute self-limited colitis (acute infectious-type colitis). Am J Surg Pathol 6:523–529, 1982
Boyd JF: Pathology of the alimentary tract inSalmonella typhimurium food poisoning. Gut 26:935–944, 1985
Pickering LK, Dupont HL, Olarte J, Conklin R, Ericsson C: Fecal leukocytes in enteric infections. Am J Clin Pathol 68:562–565, 1977
Stoll BJ, Glass RI, Banu H, Huq MI, Khan MU, Ahmed M: Value of stool examination in patients with diarrhea. Br Med J 286:2037–2040, 1983
Jewkes J, Larson HE, Price AB, Sanderson PJ, Davies HA: Aetiology of actue diarrhea in adults. Gut 22:388–392, 1981
Mandal BK, Mani V: Colonic involvement in salmonellosis. Lancet 1:887–888; 2:102, 1976
Boyd JF: Colonic involvement in salmonellosis. Lancet 1:1415, 1976
Appelbaum PC, Scragg J, Schonland MM: Colonic involvement in salmonellosis. Lancet 2:102, 1976
Speelman P, Kabir I, Islam M: Distribution and spread of colonic lesions in shigellosis: A colonscopic study. J Infect Dis 150:899–903, 1984
Cantey JR: Shiga toxin—an expanding role in the pathogenesis of infectious diseases. J Infect Dis 151:766–771, 1985
Price AB, Jewkes J, Sanderson PJ: Acute diarrhea:Campylobacter colitis and the role of rectal biopsy. J Clin Pathol 32:990–997, 1979
Mee AS, Shield M, Burke M:Campylobacter colitis: Differentiation from acute inflammatory bowel disease. J R Soc Med 78:217–223, 1985
Drake AA, Gilchrist MJR, Washington II JA, Huizenga KA, Van Scoy RE: Diarrhea due toCampylobacter fetus subspeciesjejuni. A clinical review of 63 cases. Mayo Clin Proc 56:414–423, 1981
Tedesco FJ: Antibiotic-associated pseudomembranous colitis with negative proctosigmoidoscopy examination. Gastroenterology 77:295–297, 1979
Alpers DH: The pseudomembranous enterocolitides.In Gastrointestinal Disease. MH Sleisenger, JS Fordtran (eds). Saunders, New York, 1978, pp 1715–1729
Pitman FE, El-Hashimi WK, Pittman JC: Studies on human amebiasis. I. Clinical and laboratory findings in eight cases of acute amebic colitis. Gastroenterology 65:581–587, 1973
Smith PD: Pathophysiology and immunology of giardiasis. Annu Rev Med 36:295–307, 1985
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T.K. was partly supported by a grant from the Medical School, University of Athens. G.E.G. acknowledges support from the Wellcome Trust.
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Kordossis, T., Joseph, A.E.A., Gane, J.N. et al. Fecal leukocytosis, indium-111-labelled autologous polymorphonuclear leukocyte abdominal scanning, and quantitative fecal indium-111 excretion in acute gastroenteritis and enteropathogen carriage. Digest Dis Sci 33, 1383–1390 (1988). https://doi.org/10.1007/BF01536992
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DOI: https://doi.org/10.1007/BF01536992