Wenger-Angritt Helicobacter stain

From:RSRICHMOND@aol.com

Last October Sue Barnes (SBarnes@elch.org) posted:  >>I am looking for the 
Wenger-Angritt stain for Helicobacter pylori. This stain was mentioned in an 
AFIP report and my pathologist would like to start doing it.<<

Apparently a recent pathology book - perhaps an AFIP fascicle on GI pathology 
- refers to this stain, apparently in use at the AFIP, and one of my locum 
tenens clients asked for it. The laboratory contacted Dr. Helen E. Remotti at 
AFIP yesterday, and she faxed a procedure. This next paragraph is mostly 
copied from that procedure:

>>This modification of Manuel's reticulum stain demonstrates some 
argyrophilic microorganisms. It is a synthesis, with modifications, of 
several silver impregnation methods, notably Gomori's original method and 
Manuel's reticulum procedure as found in the AFIP manual. The stain is done 
on paraffin sections of formalin fixed tissues. It uses the 
permanganate-metabisulfite sequence to clear the background, followed by 
uranium nitrate sensitization and modified Fontana's ammoniacal silver for 
impregnation. The wash following the silver impregnation contains the 
reducing agent (formalin) in order to minimize the loss of silver. Sections 
are checked microscopically after the reduction step. No counterstain is 
used. The treatments with gold chloride and sodium thiosulfate are omitted to 
optimize bacterial staining.<<

Besides the 1968 AFIP manual, the only reference is to the AFIP Letter, Vol 
155, No 1, page 8, February 1997.

Obviously this isn't a real-world procedure - it's time consuming, few 
clinical labs can differentiate sections under a microscope, and the uranyl 
nitrate would have the Herrn Inspektors at your door in short order. - Once 
again I ask - has this, or any silver impregnation procedure, been shown to 
be more sensitive in finding Helicobacter pylori?

Bob Richmond
Samurai Pathologist
Knoxville TN



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