Limitations of the criteria used to diagnose histologic endometritis in epidemiologic pelvic inflammatory disease research

Rodolfo D Vicetti Miguel, Mamatha Chivukula, Uma Krishnamurti, Antonio J. Amortegui, Jeffrey A. Kant, Richard L Sweet, Harold C. Wiesenfeld, Jaclyn M. Phillips, Thomas L. Cherpes

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

While endometrial neutrophils and plasma cells are criteria used to diagnose histologic endometritis in epidemiologic pelvic inflammatory disease (PID) research, plasma cell misidentification and nonspecificity may limit the accuracy of these criteria. Herein, we examined: (1) the identification of endometrial plasma cells with conventional methyl green pyronin-based methodology versus plasma cell-specific (CD138) immunostaining, (2) the prevalence of endometrial plasma cells among women at low risk for PID, and (3) endometrial leukocyte subpopulations among women diagnosed with acute or chronic histologic endometritis by conventional criteria. We observed an absence of CD138+ cells in 25% of endometrial biopsies in which plasma cells had been identified by conventional methodology, while additional immunohistochemical analyses revealed indistinguishable inflammatory infiltrates among women diagnosed with acute or chronic endometritis by conventional criteria. Among women considered at lower risk for PID development, flow cytometric analyses detected plasma cells in 30% of endometrial biopsy specimens, suggesting that these cells, even when accurately identified, only nonspecifically identify upper genital tract inflammatory processes. Combined, our findings underscore the limitations of the criteria used to diagnose histologic endometritis in PID-related research and suggest that satisfactory understanding of PID pathogenesis, treatment, and prevention is hindered by continued use of these criteria.

Original languageEnglish (US)
Pages (from-to)680-685
Number of pages6
JournalPathology Research and Practice
Volume207
Issue number11
DOIs
StatePublished - Nov 15 2011

Keywords

  • Histologic endometritis
  • Pelvic inflammatory disease
  • Plasma cell
  • Syndecan-1

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Cell Biology

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    Miguel, R. D. V., Chivukula, M., Krishnamurti, U., Amortegui, A. J., Kant, J. A., Sweet, R. L., Wiesenfeld, H. C., Phillips, J. M., & Cherpes, T. L. (2011). Limitations of the criteria used to diagnose histologic endometritis in epidemiologic pelvic inflammatory disease research. Pathology Research and Practice, 207(11), 680-685. https://doi.org/10.1016/j.prp.2011.08.007