Colon Polyps in Childhood: Increased Mucosal Eosinophilia in Juvenile Polyps
Van Vliet, C.P.
Aim: To study colon polyps in childhood, classify them according to histology and investigate the significance of colonic mucosal eosinophilia as a possible factor in the pathogenesis of juvenile polyps. Methods: The records of 128 consecutive children with colon polyps diagnosed in our endoscopy unit from 1987 to 2007 were reviewed. Polyps were classified according to location and histological characteristics. The association between juvenile polyps and mucosal eosinophilia was studied. Results: The mean age for polyp diagnosis was 5±3.2 years. One-hundred and twenty-one children (94.53%) had a solitary juvenile polyp, 3 juvenile polyposis coli (3.34%), 3 (3.34%) multiple adenomatous colonic polyps, and one Peutz-Jeghers syndrome. Polyps were more prevalent in the rectosigmoid. Simultaneous colonic biopsies were taken in 92 children. Among children with juvenile polyps 73 (82.95%) had prominent eosinophilic infiltration of the polyp and 67 children (76.14%) eosinophilic infiltration of the colonic mucosa. Eosinophilia correlated inversely with patient’s age (p < 0.01) and positively with the size of the polyp (p < 0.05). Conclusions: In our series most colonic polyps in children are juvenile and solitary. The prominent eosinophilic infiltration of both the polyp and the adjacent colonic mucosa may support an allergic aetiology in the pathogenesis of colon juvenile polyps.