[Histonet] Re: H. Pylori Testing

[Bob Richmond]

Helicobacter heilmannii (sorry I misspelled it before) was named
Gastrospirillum hominis when it was first described. Tight cylindrical
spirals, unlike the "gull-wing" (like you learned to draw birds in the sky
when you were in the fourth grade) morphology of H. pylori. I'm not sure
you could see those tight cylindrical spirals clearly using IHC, and tell
them from gull-wings.

Sensitivity on Giemsa staining depends on microscopic technique. Real men
don't use oil immersion in pathology, but you need an oil lens to make the
morphologic confirmation, and to search the occasional slide that has
neutrophils in the pyloric lamina propria (chronic active gastritis), and
this is time-consuming and messy, and few pathologists do it.

Bob Richmond
Samurai Pathologist
Maryville TN

On Wed, Apr 29, 2015 at 2:18 PM, Garreyf <garreyf <@t> gmail.com> wrote:

> In the past when using giemsa stain,
> I came across two human cases of very long helicobacter organisms.. I was
> stumped the first time since I had never seen one previously. I reflexed
> both to immuno and both were positive with the h pylori antibody. I assume
> they were both heilmani. I think it was called gastrospirillum in the
> past.I agree the immuno stain is much faster (easier)to look at.  I've
> never studied it but it's sensitivity is probably just a little better than
> giemsa. It's those cases with very few organisms that are more apt to  be
> missed using a non-immuno type of stain.  Agree about the contaminants as
> well .... we alway went on the seagull shaped morphology though.
>
>
> Garrey
>
> Sent from my iPhone
>
> > On Apr 29, 2015, at 2:04 PM, Bob Richmond <rsrichmond <@t> gmail.com> wrote:
> >
> > Nancy Stedman observes:
> >
> >>> I believe IHC is more sensitive than the special stains too. One caveat
> > for anyone who works with veterinary samples - the H. pylori antibodies
> are
> > specific for H. pylori, so I have not found these antibodies to be
> helpful
> > for evaluating other species with helicobacter-associated gastritis. One
> > exception is the antibody made by Biocare which seems to stain some of
> the
> > feline helicobacters, and maybe others too (have not tried).<<
> >
> > As far as I know, the only Helicobacter species other than H. pylori
> > reported as a human pathogen is H. heilmanii - I've seen it exactly once,
> > with a dye method - supposedly more common in Japan, often with a history
> > of close association with cats. Supposedly H. heilmanii marks with the
> > commercial IHC antibodies also.
> >
> > I don't think the data exist to show that IHC is more sensitive than the
> > older dye methods, in terms of detecting clinical disease. As I noted
> > before, the IHC is much faster for the pathologist to read. Also, many
> > pathologists report any bacteria seen with dye methods as H. pylori,
> > including the bacteria brought down by the endoscope from the oral
> cavity.
> >
> > Bob Richmond
> > Samurai Pathologist
> > Maryville TN
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