Borley et al reported a histopathologic score to describe the ileum in patients with Crohn's disease. This was slightly modified by Steward et al by the inclusion of a subscore for neutrophilic infiltrate. The authors are from John Radcliffe Hospital in Oxford.
Patient selection: Crohn's disease
Parameters (first 3 reported by Borley et al, fourth added by Steward):
(1) mucosal ulceration
(2) mural edema
(3) depth of neutrophilic penetration
(4) increase in neutrophils
Parameter
Finding
Points
mucosal ulceration
none
0
aphthous ulcer (< 7 mm)
1
linear ulcer
2
confluent large ulcer
3
mural edema
none
0
mild
1
moderate
2
severe
3
depth of neutrophilic penetration
none
0
mucosa
1
submucosa
2
muscularis
3
serosa and extramural fat
4
increase in neutrophils
none
0
mild
1
moderate
2
severe
3
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 13
• The higher the score the more severe the acute inflammation.
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