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Brown bowel syndrome |
(1) Normal mucosa detected by endoscopy and histology (if no overlapping disease) |
(2) PAS-positive pigments in smooth muscle cells of the muscularis propria |
(3) EM: osmophilic pigments |
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Infection (Whipple disease and mycobacterium) |
(1) Traveling or close contacting history |
(2) Abnormal endoscopic findings |
(3) PAS-positive granules in macrophages in lamina propria |
(4) IHC for microorganism |
(5) Normal muscularis propria |
(6) EM: bacteria |
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Melanosis coli or duodeni |
(1) Usually no clinical symptoms |
(2) History of usage of anthraquinone laxatives or renal disease |
(3) Dark endoscopic mucosa |
(4) PAS-positive granules in macrophages in lamina propria |
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Celiac disease |
(1) Inflamed duodenum detected by an endoscopy: scalloping or flattening of duodenal folds, fissuring over the folds, and a mosaic pattern of mucosa of folds |
(2) Destruction of mucosa by intraepithelial lymphocytes |
(3) Positive serology: antitransglutaminase antibodies, antiendomysial antibodies, and antigliadin antibodies |
(4) Response to gluten-free products |
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Inflammatory bowel disease |
(1) Bloody diarrhea |
(2) Abnormal endoscopic findings: inflammation, ulcer, and loss of vascularity |
(3) Active and chronic inflammation in mucosa or granuloma and transmural inflammation (Crohn’s disease) |
(4) No pigments seen |
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