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== Synonyms ==
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== Synonyms ==
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Porcine intestinal adenomatosis
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Porcine intestinal adenomatosis or Porcine Proliferative Enteropathy
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== Introduction ==
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This is a disease caused by the obligatory intracellular organism Lawsonia intracellularis, a spirochete that does not grow well in the laboratory excpet in tissue culture. It is only seen in pigs, worldwide, including&nbsp;the United Kingdom. It is characterised by proliferative&nbsp;changes in&nbsp;the epithelium of the&nbsp;small and large intestinal mucosa.&nbsp;<br>It is a disease that can affect pigs of all ages, but most severe clinical signs tend to appear in weanlings and growers.
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Characteristic proliferation of mucosa.
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The disease appears in four different presentations:<br>'''Intestinal adenomatosis <br>'''The basic hyperplastic and metaplastic changes are seen in the epithelium, which causes&nbsp;chronic weight loss and diarrhoea. <br>'''Necrotic enteritis''' <br>Predominately affects the colon and terminal ileum. <br>Parts of the hyperplastic mucosa develop erosions and ulcerations. <br>These areas become colonised by Fusiformis baceria. <br>Gives areas of coagulative necrosis covered by a thick diptheretic membrane. <br>Terminal ileitis <br>Characterised by marked hypertrophic thickening of the muscular portion of the wall of the terminal ileum. <br>Gives an attendant stenosis of the lumen of the ileum. <br>There is associated thickening of the mucosa due to hypertrophy and secondary granulomatous inflammation. <br>This is presumably caused by a degree of obstruction to the passage of ingesta along the bowel caused by the mucosal hypertrophy. <br>Appears very similar to Johnes disease <br>Lots of mononuclear cells and a chronic granulomatous type of inflammation. <br>Proliferative haemorrhagic syndrome. <br>The bowel shows proliferation but with ulceration and copious haemorrhage into the bowel lumen. <br>Animals are often be found dead. <br>The pathogenesis is unclear. <br>May involve a type of hypersensitivity reaction or secondary infection of some type. <br>
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<br><br>
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==== Clinical  ====
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==== Clinical ====
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*Can affect all ages of pig.
 
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*Really only seen in the pig.
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**Can affect all ages of pig.
   
*Clinical signs are variable.  
 
*Clinical signs are variable.  
 
**Anything from poor weight gain to diarrhoea, weight loss, cachexia and death.
 
**Anything from poor weight gain to diarrhoea, weight loss, cachexia and death.
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**Not seen in pigs with lots of other pathogens in guts.
 
**Not seen in pigs with lots of other pathogens in guts.
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==== Pathogenesis ====
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==== Pathology ====
 
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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 ====
      
*The terminal [[Small Intestine Overview - Anatomy & Physiology|small intestine]] and [[Colon - Anatomy & Physiology|colon]] are affected by proliferation of the mucosal epithelium.  
 
*The terminal [[Small Intestine Overview - Anatomy & Physiology|small intestine]] and [[Colon - Anatomy & Physiology|colon]] are affected by proliferation of the mucosal epithelium.  
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<br>
 
<br>
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*Porcine adenomatosis complex can be divided into four distinct syndromes:
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==== Sequelae ====
*#'''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|colonised]] 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 ====
      
*Resolution.  
 
*Resolution.  
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