What should be the treatment for intestinal neuronal dysplasia type B? A comparative long-term follow-up study

Lourenção, Pedro Luiz Toledo de Arruda; Ortolan, Érika Veruska Paiva; Rosa, Laura Luiza Minelli; Angelini, Marcos Curcio; Cassettari, Vanessa Mello Granado; Terra, Simone Antunes; Rodrigues, Maria Aparecida Marchesan

doi:10.1016/j.jpedsurg.2020.11.019

Cited by 5 publications

(12 citation statements)

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Section: Introductionmentioning

confidence: 99%

“…Two therapeutic modalities have been used in patients with IND-B: conservative clinical therapy and surgical treatment [ 7 , 18 , 19 ]. Conservative therapy is composed of changes in diet, laxatives, and enemas in cases of fecal retention [ 4 , 19 , 20 ]. Surgical treatment includes sphincterotomy, extensive surgical resection, or temporary colostomy [ 21 , 22 , 23 , 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

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Association between Clinical and Histopathological Findings in Intestinal Neuronal Dysplasia Type B: An Advance towards Its Definition as a Disease

Gonçalves

Oliveira

Filho

et al. 2023

Life

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Introduction: Intestinal neuronal dysplasia type B (IND-B) is a controversial entity that affects the submucosal nerve plexus of the distal intestine. The lack of definition of the causal relationship between histological findings and clinical symptoms has been identified as the primary point to be elucidated in the scientific investigation related to IND-B, which is essential for it to be considered a disease. Objective: To investigate the relationship between histopathological findings and symptoms in a series of patients with IND-B. Methods: Twenty-seven patients with histopathological diagnosis of IND-B, according to the Frankfurt Consensus (1990), who underwent surgical treatment through colorectal resections were included. Data from medical records regarding the clinical picture of the patients at the time of diagnosis, including the intestinal symptom index (ISI) and a detailed histopathological analysis of the rectal specimens, were retrieved. Exploratory factor analysis was performed, applying the principal components method for clusters with Varimax rotation. Results: Two factors were determined: the first, determined by histopathological and clinical variables, and the second, composed of the main symptoms presented in patients with IND-B, including ISI. Factorial rotation showed the association between the two factors and, through a graph, demonstrated the proximity between ISI values and histopathological alterations. Conclusion: There was evidence of an association between the clinical features presented by patients with IND-B and the histopathological findings of the rectal samples. These results support the understanding of IND-B as a disease.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association between Clinical and Histopathological Findings in Intestinal Neuronal Dysplasia Type B: An Advance towards Its Definition as a Disease

Gonçalves

Oliveira

Filho

et al. 2023

Life

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

“…Two therapeutic modalities have been used in patients with IND-B: conservative clinical treatment and surgical treatment[ 9 , 20 ]. Conservative treatment is based on changes in diet, laxatives, and enemas in cases of fecal retention[ 7 , 20 , 21 ]. Surgical treatment can be performed through sphincterotomy, extensive surgical resection, or temporary colostomy[ 22 - 25 ].…”

Section: Introductionmentioning

confidence: 99%

“…Surgical treatment can be performed through sphincterotomy, extensive surgical resection, or temporary colostomy[ 22 - 25 ]. However, the outcomes obtained using different treatment modalities show conflicting results[ 11 , 20 , 21 ]. Currently, the most accepted trend is that patients diagnosed with IND-B who have no complications must receive conservative treatment[ 1 , 3 , 10 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

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Challenges in the diagnosis of intestinal neuronal dysplasia type B: A look beyond the number of ganglion cells

Terra¹,

Gonçalves²,

Lourenção³

et al. 2021

WJG

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Intestinal neuronal dysplasia type B (IND-B) is a controversial condition among gastrointestinal neuromuscular disorders. Constipation is its most common clinical manifestation in patients. Despite intense scientific research, there are still knowledge gaps regarding the diagnostic criteria for IND-B in the histopathological analysis of rectal biopsies. The guidelines published in the past three decades have directed diagnostic criteria for quantifying the number of ganglion cells in the nervous plexus of the enteric nervous system. However, it is very complex to distinguish numerically what is pathological from what is normal, mainly because of the difficulty in determining a reliable control group composed of healthy children without intestinal symptoms. Thus, a series of immunohistochemical markers have been proposed to assist in the histopathological analysis of the enteric nervous system. Several of these markers facilitate the identification of other structures of the enteric nervous system, in addition to ganglion cells. These structures may be related to the etiopathogenesis of IND-B and represent new possibilities for the histopathological diagnosis of this disease, providing a view beyond the number of ganglion cells. This review critically discusses the aspects related to the disease definitions and diagnostic criteria of this organic cause of constipation.

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Intestinal neuronal dysplasia type B of the duodenum in an adolescent patient

Morales

Fleming

Esdaille

et al. 2022

Journal of Pediatric Surgery Case Reports

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What should be the treatment for intestinal neuronal dysplasia type B? A comparative long-term follow-up study

Cited by 5 publications

References 36 publications

Association between Clinical and Histopathological Findings in Intestinal Neuronal Dysplasia Type B: An Advance towards Its Definition as a Disease

Association between Clinical and Histopathological Findings in Intestinal Neuronal Dysplasia Type B: An Advance towards Its Definition as a Disease

Challenges in the diagnosis of intestinal neuronal dysplasia type B: A look beyond the number of ganglion cells

Intestinal neuronal dysplasia type B of the duodenum in an adolescent patient

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