J Med Assoc Thai 2000; 83 (11):1402

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Immunohistochemistry for Intestinal Ganglion Cells and Nerve Fibers: Aid in the Diagnosis of Hirschsprung's Disease
Petchasuwan C Mail, Pintong J

Hirschsprung's disease is a disease of congenital abnormalities characterized by absence
of the enteric ganglion cell of the colon. To make a definite diagnosis, biopsy of the aganglionic
zones of colon is required. A specimen from submucosal biopsy of the colon is very small and
difficult to identify submucosal ganglion cells. Our study reports an immunohistochemical
technique to detect submucosal ganglion cells. Six antineural markers, peripherin, cathepsin D,
PGP 9 .5, synaptophysin, chromogranin and S-100 protein, were used. The best antibody for the
detection of submucosal ganglion cells in our study was peripherin. The additional measurement
of nerve fiber caliber using S-100 protein staining is a valuable aid in the diagnosis of Hirsch-
sprung's disease. It can be applied to the suction submucosal biopsy in a patient suspected of
having Hirschsprung's disease, therefore, the complicated full thickness colonic and rectal biopsy
can be avoided.
Key word : Hirschsprung's Disease, Ganglion Cells, Immunohistochemistry

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