Rath et al proposed a histologic score for evaluating colon biopsies for experimental rats with hemorrhagic colitis. The same score can be applied to patients with hemorrhagic colitis.
Parameters:
(1) mucosal inflammation
(2) epithelial alterations
(3) mucosal hemorrhage
(4) mucosal erosions
|
Parameter |
Finding |
Points |
|
mucosal inflammation |
none |
0 |
|
|
neutrophils in lamina propria |
1 |
|
|
neutrophils among epithelial cells, with cryptitis |
2 |
|
|
crypt abscesses |
3 |
|
epithelial alterations |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
|
mucosal hemorrhage |
none |
0 |
|
|
mild and focal |
1 |
|
|
moderate and focal |
2 |
|
|
diffuse and severe |
3 |
|
mucosal erosions |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
where:
• Epithelial alterations include loss of goblet cells, anisnucleosis (variation in nuclear size), mitotic activity and apoptosis.
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0 = normal mucosa
• maximum score: 12
• The higher the score the more severe the colitis.
Specialty: Gastroenterology
