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== Synonyms ==
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#redirect[[Lawsonia intracellularis]]
 
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Porcine intestinal adenomatosis
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Characteristic proliferation of mucosa.
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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 Overview - 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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<br>
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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|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 ====
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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).
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[[Category:Enteritis,_Proliferative]] [[Category:Intestinal_Diseases_-_Pig]] [[Category:Enteritis,_Bacterial]] [[Category:To_Do_-_Kate]]
 
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