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伴有和不伴有低白蛋白血症的慢性炎症性肠病犬肠道活检样本的组织病理学特征

Histopathologic Characteristics of Intestinal Biopsy Samples from Dogs With Chronic Inflammatory Enteropathy With and Without Hypoalbuminemia.

作者信息

Wennogle S A, Priestnall S L, Webb C B

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, CO.

Department of Pathology and Infectious Diseases, Royal Veterinary College, University of London, North Mymms, UK.

出版信息

J Vet Intern Med. 2017 Mar;31(2):371-376. doi: 10.1111/jvim.14669. Epub 2017 Mar 3.

Abstract

BACKGROUND

Previous studies have identified hypoalbuminemia as a risk factor for negative outcome in dogs with chronic enteropathy (CE), but it has not been determined whether histopathology differs between CE dogs with and without hypoalbuminemia.

OBJECTIVE

To compare histopathologic findings in dogs with biopsy-diagnosed inflammatory CE with and without hypoalbuminemia.

ANIMALS

83 dogs that had intestinal biopsy performed between January 2010-July 2015. Dogs had signs compatible with CE of at least 3-weeks' duration and no evidence of clinically relevant extra-gastrointestinal (GI) disease or potential non-GI causes of hypoalbuminemia. Dogs had primary diagnosis of inflammatory enteritis based on histopathology.

METHODS

Dogs were grouped into CE with normoalbuminemia (CEN; serum albumin concentration ≥3.0 g/dL, N = 46) or chronic enteropathy with hypoalbuminemia (CEH; serum albumin concentration <3.0 g/dL, N = 37). A pathologist (SLP) blinded to the groups reviewed biopsy samples and applied the World Small Animal Veterinary Association scoring system to all samples.

RESULTS

Intestinal biopsy samples from dogs in the CEH group were significantly more likely to display villous stunting, epithelial injury, crypt distension, and lacteal dilatation, and were more likely to have intraepithelial lymphocytes and lamina propria neutrophils than biopsy samples from dogs in the CEN group. Additionally, higher scores for each of the above listed histopathologic criteria were associated with a lower serum albumin concentration.

CONCLUSIONS AND CLINICAL IMPORTANCE

Histopathologic features of chronic inflammatory enteropathy differ between dogs that are hypo- versus normoalbuminemic. Additional work is needed to elucidate the clinical relevance of these differences.

摘要

背景

先前的研究已将低白蛋白血症确定为慢性肠病(CE)犬预后不良的一个危险因素,但尚未确定低白蛋白血症的CE犬与无低白蛋白血症的CE犬之间的组织病理学是否存在差异。

目的

比较经活检诊断为炎症性CE的低白蛋白血症犬与无低白蛋白血症犬的组织病理学发现。

动物

2010年1月至2015年7月间接受肠道活检的83只犬。这些犬具有至少持续3周的与CE相符的体征,且无临床相关的胃肠外(GI)疾病证据或低白蛋白血症的潜在非GI病因。根据组织病理学,这些犬的初步诊断为炎症性肠炎。

方法

将犬分为正常白蛋白血症的CE(CEN;血清白蛋白浓度≥3.0 g/dL,N = 46)或低白蛋白血症的慢性肠病(CEH;血清白蛋白浓度<3.0 g/dL,N = 37)。一位对分组不知情的病理学家(SLP)检查活检样本,并对所有样本应用世界小动物兽医协会评分系统。

结果

与CEN组犬的活检样本相比,CEH组犬的肠道活检样本更有可能出现绒毛发育不良、上皮损伤、隐窝扩张和乳糜管扩张,且更有可能出现上皮内淋巴细胞和固有层中性粒细胞。此外,上述每项组织病理学标准的较高分数与较低的血清白蛋白浓度相关。

结论及临床意义

低白蛋白血症犬与正常白蛋白血症犬的慢性炎症性肠病的组织病理学特征不同。需要进一步开展工作以阐明这些差异的临床相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7554/5354060/b6da55d5c1f0/JVIM-31-371-g001.jpg

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