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===Porcine Adenomatosis Complex===
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===[[Porcine Adenomatosis Complex]]===
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* Characteristic proliferation of mucosa.
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* Known as PIA - porcine intestinal adenomatosis.
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====Clinical====
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* Really only seen in the pig.
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** Can affect all ages of pig.
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* Clinical signs are variable.
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** Anything from poor weight gain to diarrhoea, weight loss, cachexia and death.
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* Seen often as problem in closed, low infection herds. 
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** Not seen in pigs with lots of other pathogens in guts.
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====Pathogenesis====
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* Caused by [[Lawsonia intracellularis|''Lawsonia intracellularis'']].
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** A spirochete that does not grow well except in tissue culture.
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====Pathology====
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* The terminal [[Small Intestine - Anatomy & Physiology|small intestine]] and [[Colon - Anatomy & Physiology|colon]] are affected by proliferation of the mucosal epithelium.
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* '''Gross'''
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** Thickened mucosal epithelium.
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** Has almost polypoid-like nodules several millimetres in diameter.
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** Undifferentiated epithelium replaces goblet cells.
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*** Appears almost neoplastic.
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* '''Histologically'''
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** Very similar to a virus induced proliferation.
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** Organisms seen in the apical part of epithelial cells lining glands of terminal [[Ileum - Anatomy & Physiology|ileum]], [[Colon - Anatomy & Physiology|colon]] and [[Caecum - Anatomy & Physiology|caecum]].
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** May produce mild ulceration in mucosa and mild inflammatory infiltration.
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* Porcine adenomatosis complex can be divided into four distinct syndromes:
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*# '''Intestinal adenomatosis'''
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*#* THe basic hyperplastic and metaplastic changes are seen in the epithelium. [[Image:porcine intestinal adenomatosis campylobacter.jpg|thumb|right|150px|Campylobacter mucosalis in intracellular porcine intestinal adenomatosis (Courtesy of Bristol BioMed Image Archive)]]
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*#* Causes chronic weight loss and diarrhoea.
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*# '''Necrotic enteritis'''
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*#* Predominately affects the [[Colon - Anatomy & Physiology|colon]] and terminal [[Ileum - Anatomy & Physiology|ileum]].
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*#* Parts of the hyperplastic mucosa develop erosions and ulcerations.
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*#** These areas become [[Colon - Anatomy & Physiology|colon]]ised by ''Fusiformis'' baceria.
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*#*** Gives areas of coagulative necrosis covered by a thick diptheretic membrane.
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*# '''Terminal ileitis'''
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*#* Characterised by marked hypertrophic thickening of the muscular portion of the wall of the terminal [[Ileum - Anatomy & Physiology|ileum]].
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*#* Gives an attendant stenosis of the lumen of the [[Ileum - Anatomy & Physiology|ileum]].
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*#* There is associated thickening of the mucosa due to hypertrophy and secondary granulomatous inflammation.
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*#** This is presumably caused by a degree of obstruction to the passage of ingesta along the bowel caused by the mucosal hypertrophy.
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*#* Appears very similar to Johnes disease
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*#** Lots of mononuclear cells and a chronic granulomatous type of inflammation.
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*# '''Proliferative haemorrhagic syndrome'''.
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*#* The bowel shows proliferation but with ulceration and copious haemorrhage into the bowel lumen.
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*#* Animals are often be found dead.
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*#* The pathogenesis is unclear.
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*#** May involve a type of hypersensitivity reaction or secondary infection of some type.
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====Sequelae====
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* Resolution.
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* Necrotic enteritis.
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* Secondary chronic infection (regional enteritis).
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* Porcine haemorrhgaic enteritis (PHE).
   
[[Category:Intestine_-_Inflammatory_Pathology_by_Type]]
 
[[Category:Intestine_-_Inflammatory_Pathology_by_Type]]
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