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Enteritis, Lymphocytic - Plasmacytic (view source)
Revision as of 14:00, 24 May 2011
, 14:00, 24 May 2011no edit summary
* Is idiopathic, but appears to be immune mediated.
==Signalment==
*Often affects older animals but kittens of 16 weeks old and puppies of 20 weeks old have been reported.
*Basenjis have been reported to suffer from a severe form known as immunoproliferative disease.
**** Disease is often due to something present in the diet for some time, rather than something suddenly introduced.
==Description==
'''Lymphocytic - plasmacytic enteritis (LPE)''' is the most common form of [[Inflammatory Bowel Disease|Inflammatory Bowel Disease]] (IBD). As its name suggests, the predominant cell type in the intestinal mucosa is [[Lymphocytes - Introduction|'''lymphocytes''']] and '''plasma cells'''. Enteric parasites, bacteria in dogs and [[Toxoplasma gondii|''Toxoplasma'']] in cats have been reported to associated with LPE. This disorder in cats have also been shown to associate with concurrent disease of the pancreas and liver such as [[Pancreatitis|pancreatitis]], [[Cholangitis|cholangitis]] and [[Hepatic Lipidosis|hepatic lipidosis]]. LPE is believed to be caused by an abnormal [[Regional Lymphoid Tissue - Anatomy & Physiology|mucosal associated lymphoid tissue (MALT)]] response to luminal bacterial, dietary or self-antigens.
** Produces chronic diarrhoea with lymphocytic or plasma cell (rather than macrophage) infiltration of the lamina propria.
The [[Small Intestine Overview - Anatomy & Physiology|small intestines]] are affected to a variable degree of severity. It has also been known to affect other parts of the gastrointestinal tract such as the [[:Category:Stomach and Abomasum - Pathology|stomach]] and the [[Colon - Anatomy & Physiology|colon]]. In severely affected animals, this will result in a protein-losing enteropathy (PLE).
** Produces a severe [[Intestines Protein-Losing Diseases - Pathology#Protein-Losing Enteropathy (PLE)|protein losing enteropathy]].
* Sometimes eosinophil infiltration is quite marked.
==Diagnosis==
* Has a hereditary basis in the Basenji
===Clinical Signs===
Most common:
*small intestinal diarrhoea
*weight loss
*protein - losing enteropathy in severe cases
*chronic vomiting (more common presentation in cats compared to the other signs)
*thickened small intestinal loops and mesenteric lymphadenopathy may be detected on physical examination in cats
Others:
*appetite changes
*excessive borborygmi
*abdominal discomfort
*ascites or subcutaneous oedema if severe PLE resulting in hypoproteinaemia
*concurrent systemic immune-mediated response and [[Thromboembolism|thromboembolism]] (rare)
===Laboratory Tests===
====Haematology====
*Panhypoproteinaemia (non-specific)
====Biochemistry====
*Leucocytosis (non-specific)
====Other Tests====
*Serum trypsin-like immunoassay (TLI) to rule out [[Exocrine Pancreatic Insufficiency|exocrine pancreatic insufficiency (EPI)]].
*Faecal analysis to rule out endoparasite and pathogenic bacteria.
===Diagnostic Imaging===
*Abdominal radiography is unremarkable, but it can be used to eliminate other differential diagnosis.
*Abdominal ultrasonography may reveal thickened intestinal walls, mesenteric lymphadenopathy or abdominal effusion.
===Histopathology===
Intestinal biopsy is needed for a definitive diagnosis once all the other differential diagnoses have been eliminated.
Refer to [[Inflammatory Bowel Disease#Lymphocytic - Plasmacytic Enteritis|Lymphocytic - Plasmacytic Enteritis]] for pathology.
==Treatment==
Refer to [[Inflammatory Bowel Disease#Treatment|IBD]]
==Prognosis==
Refer to [[Inflammatory Bowel Disease#Prognosis|IBD]]
==References==
*Ettinger, S.J. and Feldman, E. C. (2000) '''Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2''' (Fifth Edition) ''W.B. Saunders Company''.
*Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''
*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.
==Lymphocytic - Plasmacytic Enteritis==
====Pathology====
* Hypersensitivity reaction results in increased GIT permeablility and recruitment of inflammatory cells.
* Histologically:
** Mucosal epithelial-glandular alterations.
** Variably increased mucosal infiltrate of lymphocytes and plasma cells.
*** In these dogs there is an increase in the number of [[IgA]] and [[IgG]] containing cells and CD3+ T-cells.
**** Can develop into lymphoma.
*** Changes in the relative and absolute numbers of plasma cells and lymphocytes have been associated with IBD in humans.
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[[Category:Intestine_-_Inflammatory_Pathology_by_Type]][[Category:To_Do_-_Alimentary]][[Category:To Do - Medium]]