Relationship of nerve diameter using S-100 immunohistochemistry with Hirschsprung-associated enterocolitis degrees

Abstract

Hirschsprung-associated enterocolitis (HAEC) is a complication with a multifactorial etiology that can cause morbidity and mortality in patients with Hirschsprung disease (HSCR). The histopathological degree of HAEC according to Teitelbaum's criteria can be used to predict the clinical development of HAEC. S-100 immunohistochemistry identifies enteric ganglion cells and nerve cell proliferation, the absence of ganglion cells, and hypertrophy of nerve fibers – all features of HSCR. Patients were children with HSCR who underwent leveling colostomy or a pull-through procedure; this sample came from the ganglionic segment of dilatation in the distal zone. The histopathological grade of HAEC was examined, and the size of the nerve diameter was measured by immunohistochemical S-100. Data were analyzed with the Spearman rank test and the Fisher's exact test. This study had 26 samples, dominated by boys (73.1%) and the age group 2–3 years (38.5%). The histopathological class distribution was reasonably fair except for class V, where no sample was found in this group. Measurement of the dominant nerve diameter was a size of ≥40 μm (84.6%). Statistically, the p-value was not significant to confirm the relationship between histopathological class size and size of nerve diameter (r = 0.067). If the diameter of the nerve experiencing hypertrophy is higher, the risk of HAEC is greater, but this relationship is not statistically significant.

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