Morphometric analysis of crypt villous ratio in tropical sprue and its phenotypical correlation

Ramya, R (2020) Morphometric analysis of crypt villous ratio in tropical sprue and its phenotypical correlation. Masters thesis, PSG Institute of Medical Sciences and Research, Coimbatore.


Download (8MB) | Preview


INTRODUCTION: Malabsorption is characterized by defective absorption of water, fat soluble vitamins, fat and all other nutrients including electrolytes and water. The etiological factors for malabsorptive disorders are varied of which celiac disease and tropical sprue are most common. Pathologists rely on the morphological changes in the mucosa namely villous blunting, crypt elongation, budding, hyperplasia, presence of intra epithelial lymphocytosis, basement membrane thickening etc. for making a diagnosis. Therefore the villous height, crypt depth and villous crypt ratio in duodenal biopsies of patients with tropical sprue or analysed and to correlate with the clinical features of diarrhea and megaloblastic anaemia. AIMS AND OBJECTIVES: 1. To assess villous and crypt ratio in duodenal biopsies reported as tropical sprue using Morphometry analysis grid in the Nikon eclipse Ci microscope. 2. To correlate these changes with the clinical presentation. MATERIALS AND METHODS: This is a retrospective observational study on duodenal biopsies reported as tropical sprue during 2015-2018. INCLUSION CRITERIA: All well oriented duodenal biopsies reported as tropical sprue from both sexes above 18 years of age. EXCLUSION CRITERIA: Duodenal biopsies with other diagnosis, poorly oriented and tangentially cut sections. Once cases were selected, blocks were retrieved, sections were cut and stained with H & E stain and then evaluated. The villi height and crypt depth were measured using the morphometric grid attached to NIKON eclipse Ci microscope. For each case the villous crypt ratio of both normal and diseased segments were then calculated. A villous crypt ratio of >3:1 considered normal. The ratio of diseased villi and crypt were graded as mild, moderate and severe using the following criteria.19 (Morphologic spectm.Jcdr). <3:1 to 2:1- mild, <2:1 to 1:1-moderate and, <1:1 to 0.1:1-severe. The parameters were then matched with the age, sex and clinical features of diarrhea and megaloblastic anemia. RESULTS AND OBSERVATION: It was observed that among the 485 specimens the incidence of tropical sprue was highest 123(25.4%) in the age group of 41-50 and it was less than 7% in the age group of >70 yrs. In 485 specimens analysed, 304(62.7%) were male and 181(37.3%) were female. Thus, there was a male preponderance over females. Based on the chi-square test the assessment of normal to diseased crypt found a P value of 0.934 in moderate grade. CONCLUSION: In the study we concluded that V:C ratio brought a greater number of patients in the moderate grade, 50% of the patients had chronic diarrhea, 31% had megaloblastic anemia and presence of this does not depend on the villous height or villous crypt ratio.

Item Type: Thesis (Masters)
Additional Information: 201713402
Uncontrolled Keywords: Morphometric analysis, crypt villous ratio, tropical sprue, phenotypical correlation.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 29 Jan 2021 18:30
Last Modified: 29 Jan 2021 18:30

Actions (login required)

View Item View Item