Difference between revisions of "Enteritis, Eosinophilic"

Revision as of 17:17, 12 August 2009

Signalment

Seen in any breed or age
However, more common in younger animal
More common in
- Boxers
- Dobermans
- German Shepherd Dogs

Description

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.

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.

Diagnosis

Clinical Signs

Vomiting
Diarrhoea; small intestinal is more common
- Haematoemesis or malena, and/or haematochezia; EGE is associated with mucosal erosion or ulceration
Protein-losing enteropathy in severe cases
Hypoproteinaemia in severe casese

Laboratory Tests

Haematology

Anaemia if gastrointestinal haemorrhage is severe.

Biochemistry

Eosinophilia
- This is not always present. Even when present, alone, it cannot prove the presence of EE.
- It is also a marker for parasitism, hypoadrenocorticism, allergic dermatological disease, allergic respiratory disease and mast cell tumour.
Panhypoproteinaemia
- Secoondary to concurrent protein-losing enteropathy

Diagnostic Imaging

Endoscopically, linear ulcers within the duodenal mucosa may be seen grossly.

Histopathology

Biopsy is required for a definitive diagnosis.

Treatment

Anti-parasiticide
- Fenbendazole may be given due to the possible endoparasitism or dietary sensitivity
Dietary modification
- A hypoallergenic diet should be used
Immunosuppressive therapy

Refer to IBD for further information

Prognosis

Guarded if the initial response to treatment is poor. Good if the underlying cause is detected and successfully treated.

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.

@@ Line 1: / Line 1: @@
-[[Image:eosinophilic_enteritis.jpg|thumb|right|150px|Histology of Eosinophilic enteritis in the horse <sup>©Susan Rhind, University of Edinburgh</sup>]]
+{{unfinished}}
-==Introduction==
-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; the condition is cetegorised into focal or diffuse EE.
+{{dog}}
+{{cat}}
-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.
 ==Signalment==
-Focal EE is a disease of young dogs, which can be associated with [[Toxocara canis|''Toxocara canis'']] infection. Pin-head sized white nodules can be seen under the serosa in the bowel, consisting of eosinophils, and occasionally macrophages, plasma cells and [[Toxocara canis|''Toxocara'']] larvae.
+*Seen in any breed or age
+*However, more common in younger animal
+*More common in
+**Boxers
+**Dobermans
+**German Shepherd Dogs
-The diffuse form of EE is seen in the dog, cat and horse; it is described as idiopathic but the aetiology has been suggested to be a hypersensitivity reaction. In this form of the condition, recurrent episodes of diarrhoea with tissue and circulatory eosinophilia occurs, with a heavy infiltrate of eosinophils present histologically in all layers of the stomach and intestines.
+==Description==
+'''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.
-There is a predilection for diffuse EE in:
+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.
-<gallery>
-Image:Boxer.jpg|'''Boxer'''<p><small>( © Lilly M WikiMedia Commons)</small>
-Image:GermanShep.jpg|'''German Shepherd (Alsatian)'''<p><small>( © Ellen Levy Finch WikiMedia Commons)</small>
-Image:Dobermann.jpg|'''Dobermann'''<p><small>( © John Adams WikiMedia Commons)</small>
-</gallery>
-==Clinical Signs==
+==Diagnosis==
+===Clinical Signs===
 *Vomiting
-*Diarrhoea; small intestinal is more common with haematoemesis or malena, and/or haematochezia; EGE is associated with mucosal erosion or ulceration
+*Diarrhoea; small intestinal is more common
+**Haematoemesis or malena, and/or haematochezia; EGE is associated with mucosal erosion or ulceration
 *Protein-losing enteropathy in severe cases
-*Hypoproteinaemia in severe cases
+*Hypoproteinaemia in severe casese
+===Laboratory Tests===
+====Haematology====
+*Anaemia if gastrointestinal haemorrhage is severe.
-==Laboratory Tests==
+====Biochemistry====
-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
+*Eosinophilia
+**This is not always present. Even when present, alone, it cannot prove the presence of EE.
+**It is also a marker for parasitism, hypoadrenocorticism, allergic dermatological disease, allergic respiratory disease and mast cell tumour.
+*Panhypoproteinaemia
+**Secoondary to concurrent protein-losing enteropathy
+===Diagnostic Imaging===
+*Endoscopically, linear ulcers within the duodenal mucosa may be seen grossly.
-==Diagnostic Imaging==
-Endoscopically, linear ulcers within the duodenal mucosa may be seen grossly.
 ===Histopathology===
@@ Line 33: / Line 49: @@
 ==Treatment==
-Anti-parasiticide (Fenbendazole) treatment may be given due to the possible endoparasitism or dietary sensitivity. Dietary modification is required with a change to a hypoallergenic diet.
+*Anti-parasiticide
-Immunosuppressive therapy may also be required.
+**Fenbendazole may be given due to the possible endoparasitism or dietary sensitivity
+*Dietary modification
+**A hypoallergenic diet should be used
+*Immunosuppressive therapy
+Refer to [[Inflammatory Bowel Disease - WikiClinical #Treatment|IBD]] for further information
 ==Prognosis==
 Guarded if the initial response to treatment is poor.  Good if the underlying cause is detected and successfully treated.
 ==References==
@@ Line 43: / Line 66: @@
 *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''.
-{{Learning
-|Vetstream = [https://www.vetstream.com/canis/Content/Disease/dis01035.asp, Canine eosinophillic enteritis]
-}}
-[[Category:Intestinal Diseases - Dog]][[Category:Intestine_-_Inflammatory_Pathology_by_Type]]
-[[Category:To Do - Clinical]]