NADPH-DIAPHORASE HISTOCHEMICAL STAINING OF SUCTION RECTAL BIOPSIES INTHE DIAGNOSIS OF HIRSCHSPRUNGS-DISEASE AND ALLIED DISORDERS

The purpose of this study was to investigate the specificity and sensi tivity of NADPH-diaphorase (NADPH-D) staining in suction rectal biopsi es (SRB) to determine whether it can be used as a diagnostic test for Hirschsprung's disease (HD) and related disorders. We studied SRB mate rial in 80 patients suspected of having such disorders taken at 3, 5, and 7 cm above the pectinate line. Eight-micron sections were stained with hematoxylin and eosin, acetylcholinesterase histochemistry, and N ADPH-D histochemistry. Normal biopsy specimens demonstrated strong NAD PH-D reactivity in the submucosal ganglia and a large number of NADPH- D-positive fibers in the muscularis mucosae (MM). In contrast, there w ere no NADPH-D-positive fibers in the MM in patients with HD and hyper trophic nerve trunks stained weakly. Patients with hypoganglionosis (H YPG) demonstrated only a few NADPH-D-positive fibers in the MM and sca nt submucosal ganglia. Our results show that it is possible to diagnos e HD and HYPG in mucosal rectal biopsies containing MM only and staine d by NADPH-D histochemistry. As there is no background staining in NAD PH-D histochemistry, it is easy to detect NADPH-D-positive fibers. NAD PH-D histochemical staining may be an important additional technique f or diagnosing MD and related disorders.