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有症状和无症状猫的前瞻性病例系列中三联炎的患病率及临床病理特征

Prevalence and Clinicopathological Features of Triaditis in a Prospective Case Series of Symptomatic and Asymptomatic Cats.

作者信息

Fragkou F C, Adamama-Moraitou K K, Poutahidis T, Prassinos N N, Kritsepi-Konstantinou M, Xenoulis P G, Steiner J M, Lidbury J A, Suchodolski J S, Rallis T S

机构信息

Medicine Unit, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Laboratory of Pathology, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

J Vet Intern Med. 2016 Jul;30(4):1031-45. doi: 10.1111/jvim.14356. Epub 2016 Jun 14.

Abstract

BACKGROUND

The term triaditis designates the concurrent presence of idiopathic inflammatory bowel disease (IBD), cholangitis, and pancreatitis in cats.

HYPOTHESIS/OBJECTIVES: The histopathology of concurrent, but often subclinical, inflammatory processes in the small intestine, liver, and pancreas of cats is poorly described. We aimed to investigate the frequency of enteritis, cholangitis, pancreatitis, or some combination of these in symptomatic and asymptomatic cats, compare clinicopathological features, and correlate histopathological with laboratory findings.

ANIMALS

Domestic cats (27 symptomatic, 20 asymptomatic, and 8 normal).

METHODS

Prospective study. Physical examination, laboratory variables (CBC, serum biochemistry profile, serum thyroxine concentration, serum feline trypsin-like immunoreactivity [fTLI], feline lipase immunoreactivity [fPLI, as measured by Spec fPL(®) ], urinalysis, and fecal analysis), imaging, and histopathological examinations were conducted. Feline liver, pancreas, and small intestine were biopsied during laparotomy.

RESULTS

Inflammatory lesions were detected in 47 cats (27 symptomatic, 20 asymptomatic). In total, 20 cats had histopathologic lesions of IBD (13/47, 27.7%), cholangitis (6/47, 12.8%), or pancreatitis (1/47, 2.1%) alone, or inflammation involving >1 organ (27/47, 57.4%). More specifically, 16/47 cats (34.0%) had concurrent lesions of IBD and cholangitis, 3/47 (6.4%) of IBD and pancreatitis, and 8/47 cats (17%) of triaditis. Triaditis was identified only in symptomatic cats (8/27, 29.6%). A mild, positive correlation was detected between the severity (score) of IBD lesions and the number of comorbidities (rho = +0.367, P = .022).

CONCLUSIONS AND CLINICAL IMPORTANCE

Histopathological evidence of IBD or IBD with comorbidities was detected in both symptomatic and asymptomatic cats. The possibility of triaditis should be considered in symptomatic cats with severe IBD.

摘要

背景

三联症一词指猫同时存在特发性炎症性肠病(IBD)、胆管炎和胰腺炎。

假设/目的:猫小肠、肝脏和胰腺同时存在但通常为亚临床的炎症过程的组织病理学描述较少。我们旨在调查有症状和无症状猫中肠炎、胆管炎、胰腺炎或这些疾病某种组合的发生频率,比较临床病理特征,并将组织病理学与实验室检查结果相关联。

动物

家猫(27只有症状的、20只无症状的和8只正常的)。

方法

前瞻性研究。进行体格检查、实验室检查(血常规、血清生化指标、血清甲状腺素浓度、血清猫胰蛋白酶样免疫反应性[fTLI]、猫脂肪酶免疫反应性[fPLI,通过Spec fPL(®)测量]、尿液分析和粪便分析)、影像学检查和组织病理学检查。在剖腹手术期间对猫的肝脏、胰腺和小肠进行活检。

结果

在47只猫(27只有症状的,20只无症状的)中检测到炎症性病变。总共有20只猫单独出现IBD(13/47,27.7%)、胆管炎(6/47,12.8%)或胰腺炎(1/47,2.1%)的组织病理学病变,或炎症累及多个器官(27/47,57.4%)。更具体地说,16/47只猫(34.0%)同时存在IBD和胆管炎病变,3/47只猫(6.4%)同时存在IBD和胰腺炎病变,8/47只猫(17%)存在三联症。三联症仅在有症状的猫中被发现(8/27,29.6%)。在IBD病变的严重程度(评分)与合并症数量之间检测到轻度正相关(rho = +0.367,P = 0.022)。

结论及临床意义

在有症状和无症状的猫中均检测到IBD或合并其他疾病的IBD的组织病理学证据。对于患有严重IBD的有症状猫,应考虑三联症的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f9d/5153951/39aa46e9d9a7/JVIM-30-1031-g001.jpg

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