Iancu Theodore C, Manov Irena
Pediatric Research and Electron Microscopy Unit, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Ultrastruct Pathol. 2010 May;34(3):117-25. doi: 10.3109/01913121003648410.
Although there has been substantial progress in the identification of diarrheal diseases in infancy and childhood, electron microscopy may be still required for establishing diagnosis, staging, and response to therapy. This review describes severe conditions in which histopathologic examination alone cannot provide a firm diagnosis needed for therapeutic decisions. Microvillus inclusion disease, in its several variants, typifies this category. In certain forms of congenital disorders of glycosylation with gastrointestinal involvement, electron microscopic diagnosis is helpful. Among disorders due to abnormal immune-mediated reactions, celiac disease and cow's milk protein intolerance show fine structural changes of both diagnostic and staging value. Likewise, protein-losing enteropathies, including lymphangectasia, reveal information on the nature and extent of intestinal involvement.
尽管在婴幼儿腹泻病的识别方面已取得了重大进展，但可能仍需要电子显微镜来进行诊断、分期以及评估治疗反应。本综述描述了仅靠组织病理学检查无法提供治疗决策所需确切诊断的严重病症。微绒毛包涵体病及其多种变体就是这类病症的典型代表。在某些伴有胃肠道受累的先天性糖基化障碍形式中，电子显微镜诊断很有帮助。在由异常免疫介导反应引起的疾病中，乳糜泻和牛奶蛋白不耐受表现出具有诊断和分期价值的细微结构变化。同样，包括淋巴管扩张症在内的蛋白丢失性肠病揭示了肠道受累的性质和程度方面的信息。
