Treponema pallidum Immunohistochemistry is positive in human intestinal Spirochetosis

Rondell Graham, Bita V. Naini, Sejal M Shah, Christina A. Arnold, Rajesh Kannangai, Michael Torbenson, Dora M. Lam-Himlin

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Human intestinal spirochetosis (IS) has been recognized for decades, but whether it represents commensalism or a pathogenic process remains controversial. IS is diagnosed on routine stains with confirmation by silver stains but these stains are labor intensive and slow to read. We evaluated the Treponema pallidum immunostain as a diagnostic adjunct for IS. Methods: We retrieved biopsies from 33 patients with IS for this study. Each case was tested by Warthin-Starry (WS) and T. pallidum immunohistochemistry (IHC). Species specific genotyping was performed in 3 cases. Results: Patients with IS ranged from 22 to 82 years without gender predilection. IS involved normal (n = 15), and inflamed (n = 5) mucosa and colonic polyps (n = 13). Warthin-Starry and T. pallidum IHC were positive in all cases including both species of Brachyspira. Six (18%) symptomatic patients were treated for IS, and experienced resolution. In patients diagnosed with incidental IS on cancer screening (n = 5), follow up biopsies, without therapy, were negative for IS. T. pallidum IHC required 75 min less hands-on time than WS for performance and was faster to interpret. Conclusions:T. pallidum IHC can be used to confirm the diagnosis of IS and is easier to perform and faster to interpret than WS.

Original languageEnglish (US)
Article number7
JournalDiagnostic Pathology
Volume13
Issue number1
DOIs
StatePublished - Jan 22 2018

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Treponema pallidum
Immunohistochemistry
Coloring Agents
Brachyspira
Colonic Polyps
Biopsy
Symbiosis
Early Detection of Cancer
Silver
Mucous Membrane

Keywords

  • B. Aalborgi
  • B. Pilosicoli
  • Brachyspira
  • Diarrhea
  • Intestinal spirochetosis
  • Treponema
  • Warthin-starry

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

Cite this

Treponema pallidum Immunohistochemistry is positive in human intestinal Spirochetosis. / Graham, Rondell; Naini, Bita V.; Shah, Sejal M; Arnold, Christina A.; Kannangai, Rajesh; Torbenson, Michael; Lam-Himlin, Dora M.

In: Diagnostic Pathology, Vol. 13, No. 1, 7, 22.01.2018.

Research output: Contribution to journalArticle

Graham, Rondell ; Naini, Bita V. ; Shah, Sejal M ; Arnold, Christina A. ; Kannangai, Rajesh ; Torbenson, Michael ; Lam-Himlin, Dora M. / Treponema pallidum Immunohistochemistry is positive in human intestinal Spirochetosis. In: Diagnostic Pathology. 2018 ; Vol. 13, No. 1.
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abstract = "Background: Human intestinal spirochetosis (IS) has been recognized for decades, but whether it represents commensalism or a pathogenic process remains controversial. IS is diagnosed on routine stains with confirmation by silver stains but these stains are labor intensive and slow to read. We evaluated the Treponema pallidum immunostain as a diagnostic adjunct for IS. Methods: We retrieved biopsies from 33 patients with IS for this study. Each case was tested by Warthin-Starry (WS) and T. pallidum immunohistochemistry (IHC). Species specific genotyping was performed in 3 cases. Results: Patients with IS ranged from 22 to 82 years without gender predilection. IS involved normal (n = 15), and inflamed (n = 5) mucosa and colonic polyps (n = 13). Warthin-Starry and T. pallidum IHC were positive in all cases including both species of Brachyspira. Six (18{\%}) symptomatic patients were treated for IS, and experienced resolution. In patients diagnosed with incidental IS on cancer screening (n = 5), follow up biopsies, without therapy, were negative for IS. T. pallidum IHC required 75 min less hands-on time than WS for performance and was faster to interpret. Conclusions:T. pallidum IHC can be used to confirm the diagnosis of IS and is easier to perform and faster to interpret than WS.",
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