Special staining for mast cells

Pat · Post by **Pat** » Wed Dec 04, 2013 7:52 pm

I contacted my GI doc and asked if he had requested special staining for mast cells on my colonoscopy 2 1/2 years ago. The secretary called today and said that no but he would have the pathologist do the staining now. It will take a week for results. Why else would antihistamines help me more than any other medication or supplement has before?

Pat

Post by **tex** » Wed Dec 04, 2013 8:48 pm

Hi Pat,

Please let us know what you find out.

What puzzles me is that the researchers who originally described mastocytic enterocolitis (and named it) found that (quoting from page 162 of the book):

In fact, one study showed that 70 % of patients with chronic diarrhea who had MC, celiac disease, or some other IBD, had an elevated mast cell count that qualified for a diagnosis of mastocytic enterocolitis.1

Here is the reference associated with that sentence:

1. Jakate, S., Demeo, M., John, R., Tobin,. M.,& Keshavarzian, A. (2006). Mastocytic enterocolitis: increased mucosal mast cells in chronic intractable diarrhea. Archives of Pathology & Laboratory Medicine, 130(3), 362–367. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16519565

From that abstract:

RESULTS: The mean +/- SD concentration of mast cells in the 50 control subjects was 13.3 +/- 3.5 cells per high-power field; hence, patients with more than 20 mast cells per high-power field were considered to have increased mast cells. Thirty-three (70%) of 47 patients with chronic intractable diarrhea had increased mast cells, and symptoms were controlled by drug therapy in 22 (67%) of the 33 patients. No patient had systemic or cutaneous mastocytosis. No increase in mast cells was seen in patients with other common causes of chronic diarrhea.

CONCLUSIONS: In chronic intractable diarrhea, colonic or duodenal biopsy specimens may appear unremarkable on routine hematoxylin-eosin staining, but increased mast cells may be demonstrated by immunohistochemistry for mast cell tryptase, with the novel term mastocytic enterocolitis describing this condition. Similar increases in mast cells are not apparent in control populations or in patients with other specific diseases that cause chronic diarrhea. The cause of the increased mast cells remains to be elucidated.

Obviously ME is extremely common, and yet according to results reported by members here, pathologists almost never find it. Why not? What are they doing wrong? I don't understand this at all. All the members here who find antihistamines to be so helpful would get no benefit from antihistamines if they didn't have mast cell issues. And yet the pathologists can't seem to find them?

That frustrates me no end.

Tex

Gloria · Post by **Gloria** » Wed Dec 04, 2013 9:01 pm

When I went to the dermatologist for my skin rash, I told him that I though I had a mast cell problem. I described some of my other symptoms: mouth sores, itchy bumps in the sun, heart palpitations, etc. His response: "You don't have flushing!" I gave up after that comment because I realized he had one definition of a mast cell problem.

We are in the dark ages with treating mast cells.

Pat,
I'm surprised that they still will stain your biopsy. I asked my doctor and he told me that they didn't have the stain. Then get it!!! I'm getting fed up with doctors. Read my next post and you'll see why.

Gloria

Pat · Post by **Pat** » Wed Dec 04, 2013 9:22 pm

Yes, I will post the results, but now I am not so sure they will find anything. Thanks for the info.

Pat

Gabes-Apg · Post by **Gabes-Apg** » Wed Dec 04, 2013 9:35 pm

after a fair amount of pleading.. as my GI's response was, we dont do that in Australia
to which i replied if i am going through the cost and time (and prep) for the scopes i want my monies worth!
my GI did request biopsies stained

when the results came back that there was Mast Cells, she disregarded it (my guess is, she didnt know anything about them but did not want to admit that)

I cant help but wonder ....If the mast cells results were presented in similar format as Poop or Blood results and result was in RED meaning for the doctor to take notice if it would get more serious attention....

Pat · Post by **Pat** » Tue Dec 17, 2013 8:32 pm

I received the call from my GI doc, actually his nurse. The test result was negative. I really wasn't surprised. Of course I asked her why I was doing so much better on an antihistamine and she just said I don't know. I really didn't expect any other answer.

Pat

Post by **tex** » Tue Dec 17, 2013 9:51 pm

Hmmmm. The mystery continues.

Thank you for posting the test result.

Tex

janr · Post by **janr** » Sun Jan 12, 2014 12:10 pm

I see the one of the authors of the above article practices in Chicago, a few hours from me. Since this is the only thread that came up when I searched for him I take it no one on this site has seen him. Looks interesting on paper...I might give them a call.

http://doctors.rush.edu/directory/profi ... id=0005890

Post by **tex** » Sun Jan 12, 2014 12:55 pm

Please let us know what you think, if you see him. We're always looking for doctors to add to our list.

Good luck, if you're able to set up an appointment,
Tex