Chronic Histiocystic Intervillositis (CHI)

Symptoms:

In Pregnancies less than 12 weeks

  • Spontaneous miscarriage before 12 weeks
  • High white blood cell count and/or Neutrophils, Monocytes (to be confirmed, a

number of ladies have reported this)

 

In pregnancies 12+ weeks

  • Restricted fetal growth (severe) IUGR of an otherwise chromosomal normal fetus
  • Reduced amniotic fluid
  • Early warning of fetal growth restriction is a marked slowed down in growth
  • Abnormal Doppler studies showing indicating redistribution, intermittent absent flow and then eventually reverse end diagnosic flow

 

How can we check this diagnosis?
At this time the only way to check for this diagnosis is to have an assessment of the placenta following birth or miscarriage by a pathologist who will cite CHI through checking the placenta.
It is also important to ask the Pathologist to perform CD68 Immunostaining to check the levels of this particular cell. Sufferers will have elevated numbers of these cells in the placenta.

Sources:
Boyd and Redline (“Chronic histiocytic intervillositis: a placental lesion associated with recurrent reproductive loss” Human Pathology 2000 Nov 31(11):1389-96)

  • Am J Reprod ImmunolMicrobiol. 1987;15:85:91. Fribrinoid and trophoblastic necrosis with massive chronic intervillitis: An extreme variant of villitis of unknown etiology. Labarrere CA, Mullen E.
  • Pediatric and Development Pathology. 2006;9:234‐8. Co‐occurance of Massive Perivillous Fibrin Deposition and Chronic Intervillositis: Case Report. Weber MA, Nikkels PGJ et al.
  • Gynecol Obstet Biol Reprod (Paris). 2006;35(7):711‐9. Pronostic périnatal des grossesses compliquées d’intervillites chroniques placentaires: C. Rota, D. Carles, V. Schaeffer, F. Guyon, R. Saura, J. Horovitz Rota C. et al.
  • Placenta. 2010;31:1106‐10. Chronic intervillitis of the placenta: A systemic review. Contro E. et al.
  • Placenta. 2010;31:116‐9. Pathological charactéristic of a series of rare chronic hystiocytic intervillisitis of the placenta. Traeder J. et al.
  • Chronic histiocytic intervillositis of unknown etiology: Clinical features in a consecutive series of 69 cases: Marchaudon et. Al. Placenta 2011 Feb 32(2): 140-5).
  • Massive perivillous fibrin deposition and chronic intervillositis: frequently missed diagnoses with a high recurrence risk: MA Weber, PGJ Nikkels, KE Hamoen, JJ Duvekot, RR de Krijger

Arch Pathol Lab Med. 2012;136:657–659; doi: 10.5858/arpa.2011‐0328‐OA CD68 Immunostaining in the Evaluation of Chronic Histiocytic Intervillositis Debra S Heller MD Biol Reprod (Paris). 2006 Jun;35(4):396‐404. [Association des corticoïdes à l’aspirine pour la prévention des récidives de villite ou d’intervillite chroniques d’étiologie indéterminée: G. Boog, C. Le Vaillant, F. Alnoukari, F. Jossic, J. Barrier, J.‐Y. Muller ] http://chisupport.org/wp-content/uploads/2011/12/What-is-Chronic-Histioc...