The Utility of Calretinin Immunohistochemistry in the Diagnosis of Hirschsprung’s Disease


BACKGROUND:Hirschsprung’s disease (HD) is a congenital intestinal motility disorder with absence ofganglion cells in the colonic wall, Diagnosis of the disease is based primarily onhistopathological analysis, but in this respect, there are limitations associated with standardhistology and histochemistry. Calretinin immunohistochemistry (IHC) was implemented to solve thediagnostic problems of this disease as a diagnostic marker.OBJECTIVE:We aimed to test, identify and compare the immunostaining calretinin in the aganglionic segment ofcolon specimens and to assess the diagnostic importance of the process with the normoganglionicsegment (control group).PATIENTS AND METHODS:The specimens contained 40 patients with HD histopathology and 20 others (as a control group) whowere colectomied for other reasons,60 paraffin wax blocks were analyzed for full-blown bowelspecimens and rectum biopsy. Sixty( paraffin wax) blocksof full bowel thickness and rectal biopsywere examined. In IHC stained slides, calretinine immunoreactivity and pattern of stain for ganglioncells( nuclear and cytoplasmic)and nerve fibers in different bowel layers were assessed.RESULTS:Calreinin Immunostaining was positive of ganglion cells(nuclear and cytoplasmic staining) andnerve fibers in the mucosa( lamina propria), submucosa and muscularis propria in allspecimens of control group except one case (2.5 percent), calretinin immunoexpression of ganglioncells and nerve fibers was negatively(-) ,In aganglionic segments (case group).This method hadsensitivity of 97.5% and specificity of 100% for diagnosis of HD. The positive predictivevalue was 100% and negative predictive value was 95.2%.CONCLUSION:Immunohistochemistry Calretinin can be used for the diagnosis of HD as a dependable and ancillarymethod.