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    Multiple endocrine neoplasia 2B: Differential increase in enteric nerve subgroups in muscle and mucosa.

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    Author
    Hutson, JM; Farmer, PJ; Peck, CJ; Chow, CW; Southwell, BR
    Date
    2017-08-15
    Source Title
    World Journal of Gastrointestinal Pathophysiology
    Publisher
    Baishideng Publishing Group Inc.
    University of Melbourne Author/s
    Hutson, John; Southwell, Bridget; Chow, Chung
    Affiliation
    Rural Clinical School
    Paediatrics (RCH)
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Hutson, J. M., Farmer, P. J., Peck, C. J., Chow, C. W. & Southwell, B. R. (2017). Multiple endocrine neoplasia 2B: Differential increase in enteric nerve subgroups in muscle and mucosa.. World J Gastrointest Pathophysiol, 8 (3), pp.142-149. https://doi.org/10.4291/wjgp.v8.i3.142.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/255076
    DOI
    10.4291/wjgp.v8.i3.142
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561435
    Abstract
    Multiple endocrine neoplasia 2B (MEN2B) is a rare syndrome caused by an activating mutation of the RET gene, leading to enteric gangliomatosis. This child presented with constipation at 1-mo old, was diagnosed with MEN2B by rectal biopsy at 4 mo, had thyroidectomy at 9 mo and a colectomy at 4 years. We studied the extent of neuronal and nerve fibre proliferation and which classes of enteric nerves are affected by examining the colon with multiple neuronal antibodies. Resected transverse colon was fixed, frozen, sectioned and processed for fluorescence immunohistochemistry labelling with antibodies against TUJ1, Hu, ChAT, NOS, VIP, SP and CGRP and cKit. Control transverse colon was from the normal margin of Hirschsprung (HSCR) colon (4-year-old) and a child with familial adenomatous polyposis (FAP, 12 year). Myenteric ganglia were increased in size to as wide as the circular muscle. There was a large increase in nerve cells and nerve fibres. ChAT-, NOS-, VIP- and SP-immunoreactive nerve fibres all increased in the myenteric ganglia. NOS-IR nerves preferentially increased in the muscle, while VIP and SP increased in submucosal ganglia and mucosal nerve fibres. The density of ICC was normal. RET overactivation in MEN2B lead to a large increase in intrinsic nerve fibres in the myenteric and submucosal ganglia, with a relative increase in NOS-IR nerve fibres in the circular muscle and VIP and SP in the submucosal ganglia and mucosa. The changes were associated with severe constipation resulting in colectomy at 4 years.

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