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== Synonyms  ==
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#redirect[[Lawsonia intracellularis]]
 
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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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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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==== Clinical  ====
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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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==== 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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==== 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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