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Enteritis, Eosinophilic (view source)

Revision as of 10:23, 1 November 2010

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[[Image:eosinophilic_enteritis.jpg|thumb|right|150px|Histology of Eosinophilic enteritis in the horse (Courtesy of Susan Rhind, University of Edinburgh)]]
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[[Image:eosinophilic_enteritis.jpg|thumb|right|150px|Histology of Eosinophilic enteritis in the horse <sup>©Susan Rhind, University of Edinburgh</sup>]]
 
==Introduction==
 
==Introduction==
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==Signalment==
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Eosinophilic enteritis (EE) is the second most common form of [[Inflammatory Bowel Disease#Treatment|IBD]], characterised by a mixed, but predominantly eosiphilic, mucosal inflammatory infiltration.  EGE may be limited to the small intestine or it may affect other areas of the gastrointestinal tract such as stomach or colon.
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*Seen in any breed or age
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*However, more common in younger animal
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*More common in
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**Boxers
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**Dobermans
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**German Shepherd Dogs
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An eosinophilic infiltrate may indicate a diet-induced, type 1 hypersensitivity.  However, most dogs do not respond to a purely exclusion diet.  Endoparasitism should also be excluded prior to immunosuppressive therapy for EE.
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* Can be either focal or diffuse.
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==Description==
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===Focal===
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'''Eosinophilic enteritis (EE)''' is the second most common form of IBD, characterised by a mixed, but predominantly eosiphilic, mucosal inflammatory infiltration.  EGE may be limited to the small intestine or it may affect other areas of the gastrointestinal tract such as stomach or colon.
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An eosinophilic infiltrate may indicate a diet-induced, type 1 hypersensitivity. However, most dogs do not respond to a purely exclusion diet. Endoparasitism should also be excluded prior to immunosuppressive therapy for EE.
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* A disease of young dogs.
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* Associated with [[Toxocara canis|''Toxocara canis'']] infection.
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** Pin-head sized white nodules can be seen under the serosa in the bowel.
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*** Consist of of eosinophils and occasionally macrophages and plasma cells.
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*** Can sometimes see [[Toxocara canis|''Toxocara'']] larvae in the nodules.
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==Diagnosis==
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===Diffuse===
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===Clinical Signs===
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*Vomiting
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*Diarrhoea; small intestinal is more common
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**Haematoemesis or malena, and/or haematochezia; EGE is associated with mucosal erosion or ulceration
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*Protein-losing enteropathy in severe cases
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*Hypoproteinaemia in severe casese
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* Seen in the dog, cat and horse.
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* Idiopathic
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* Has a predilection for German Shepherd Dogs, but also occcurs in other breeds of dogs and in cats.
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** Recurrent episodes of diarrhoea with tissue and circulatory eosinophilia.
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*** Eosinophils heavily infiltrate all layers of stomach and intestines.
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**It has been suggested that it is a type of hypersensitivity reaction.
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===Laboratory Tests===
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====Haematology====
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*Anaemia if gastrointestinal haemorrhage is severe.
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====Biochemistry====
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==Signalment==
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*Eosinophilia
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This condition is seen in any breed or age, but is more common in younger animals and certain breeds:
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**This is not always present. Even when present, alone, it cannot prove the presence of EE.
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*Boxers
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**It is also a marker for parasitism, hypoadrenocorticism, allergic dermatological disease, allergic respiratory disease and mast cell tumour.
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*Dobermans
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*Panhypoproteinaemia
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*German Shepherd Dogs
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**Secoondary to concurrent protein-losing enteropathy
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==Clinical Signs==
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*Vomiting
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*Diarrhoea; small intestinal is more common with haematoemesis or malena, and/or haematochezia; EGE is associated with mucosal erosion or ulceration
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*Protein-losing enteropathy in severe cases
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*Hypoproteinaemia in severe cases
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===Diagnostic Imaging===
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==Laboratory Tests==
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*Endoscopically, linear ulcers within the duodenal mucosa may be seen grossly.
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Haemotology reveals an anaemia if gastrointestinal haemorrhage is severe. Eosinophilia is not always present and even when seen it is not pathogneumonic for EE. Panhypoproteinaemia can be found secoondary to concurrent protein-losing enteropathy
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==Diagnostic Imaging==
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Endoscopically, linear ulcers within the duodenal mucosa may be seen grossly.
    
===Histopathology===
 
===Histopathology===
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==Treatment==
 
==Treatment==
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*Anti-parasiticide
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Anti-parasiticide (Fenbendazole) treatment may be given due to the possible endoparasitism or dietary sensitivity. Dietary modification is required with a chamge to a hypoallergenic diet.
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**Fenbendazole may be given due to the possible endoparasitism or dietary sensitivity
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Immunosuppressive therapy may also be required.
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*Dietary modification
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**A hypoallergenic diet should be used
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*Immunosuppressive therapy
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Refer to [[Inflammatory Bowel Disease#Treatment|IBD]] for further information
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==Prognosis==
 
==Prognosis==
 
Guarded if the initial response to treatment is poor.  Good if the underlying cause is detected and successfully treated.
 
Guarded if the initial response to treatment is poor.  Good if the underlying cause is detected and successfully treated.
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==References==
 
==References==
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==Eosinophilic Enteritis==
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[[Category:Dog]][[Category:Intestine_-_Inflammatory_Pathology_by_Type]]
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* Can be either focal or diffuse.
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===Focal===
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  −
* A disease of young dogs.
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* Associated with [[Toxocara canis|''Toxocara canis'']] infection.
  −
** Pin-head sized white nodules can be seen under the serosa in the bowel.
  −
*** Consist of of eosinophils and occasionally macrophages and plasma cells.
  −
*** Can sometimes see [[Toxocara canis|''Toxocara'']] larvae in the nodules.
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===Diffuse===
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* Seen in the dog, cat and horse.
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* Idiopathic
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* Has a predilection for German Shepherd Dogs, but also occcurs in other breeds of dogs and in cats.
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** Recurrent episodes of diarrhoea with tissue and circulatory eosinophilia.
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*** Eosinophils heavily infiltrate all layers of stomach and intestines.
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**It has been suggested that it is a type of hypersensitivity reaction.
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[[Image:eosinophilic_enteritis.jpg|thumb|right|150px|Eosinophilic enteritis - horse(Courtesy of Susan Rhind, University of Edinburgh)]]
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[[Category:Dog]][[Category:Intestine_-_Inflammatory_Pathology_by_Type]][[Category:To_Do_-_Clinical]]
 
Suzannah.stacey
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