Acquired myopathic intestinal pseudo-obstruction may be due to autoimmune enteric leiomyositis  Tarja H. Ruuska, Riitta Karikoski, Virpi V. Smith, Peter J. Milla  Gastroenterology  Volume 122, Issue 4, Pages 1133-1139 (April 2002) DOI: 10.1053/gast.2002.92396 Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 1 Biopsy 1, pretreatment. (A) H&E-stained section of biopsy 1 showing a dense lymphocytic infiltrate obscuring the circular muscle coat. (B) Immunostaining for CD3 shows that most of the lymphocytes are T cells. (C) There is a profound loss of immunostaining for α-smooth muscle actin in most of the circular muscle myocytes (original magnification 40×). Gastroenterology 2002 122, 1133-1139DOI: (10.1053/gast.2002.92396) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 2 Immunostained sections of the circular muscle coat from biopsy 3 (2 years posttreatment) showing a profound loss of enteric myocytes. Note the α-smooth muscle immunostaining confined mostly to the (A) vascular smooth muscle. Immunostaining of the circular muscle illustrates that many of the enteric and vascular leiomyocytes show (B) HLA-DR and (C) I-CAM expression (original magnification 40×). Gastroenterology 2002 122, 1133-1139DOI: (10.1053/gast.2002.92396) Copyright © 2002 American Gastroenterological Association Terms and Conditions