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犬肠道淋巴管扩张症的病理生理学、诊断与管理:一项比较性综述

Pathophysiology, Diagnosis, and Management of Canine Intestinal Lymphangiectasia: A Comparative Review.

作者信息

Jablonski Sara A

机构信息

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA.

出版信息

Animals (Basel). 2022 Oct 15;12(20):2791. doi: 10.3390/ani12202791.

Abstract

Intestinal lymphangiectasia was first described in the dog over 50 years ago. Despite this, canine IL remains poorly understood and challenging to manage. Intestinal lymphangiectasia is characterized by variable intestinal lymphatic dilation, lymphatic obstruction, and/or lymphangitis, and is a common cause of protein-losing enteropathy in the dog. Breed predispositions are suggestive of a genetic cause, but IL can also occur as a secondary process. Similarly, both primary and secondary IL have been described in humans. Intestinal lymphangiectasia is definitively diagnosed via intestinal histopathology, but other diagnostic results can be suggestive of IL. Advanced imaging techniques are frequently utilized to aid in the diagnosis of IL in humans but have not been thoroughly investigated in the dog. Management strategies differ between humans and dogs. Dietary modification is the mainstay of therapy in humans with additional pharmacological therapies occasionally employed, and immunosuppressives are rarely used due to the lack of a recognized immune pathogenesis. In contrast, corticosteroid and immunosuppressive therapies are more commonly utilized in canine IL. This review aims toward a better understanding of canine IL with an emphasis on recent discoveries, comparative aspects, and necessary future investigations.

摘要

50多年前,犬类肠淋巴管扩张症首次在犬身上被描述。尽管如此,犬类肠淋巴管扩张症仍未被充分了解,且治疗颇具挑战性。肠淋巴管扩张症的特征是肠道淋巴管可变扩张、淋巴管阻塞和/或淋巴管炎,是犬类蛋白丢失性肠病的常见病因。品种易感性提示存在遗传原因,但肠淋巴管扩张症也可能作为继发过程出现。同样,人类也有原发性和继发性肠淋巴管扩张症的描述。肠淋巴管扩张症通过肠道组织病理学确诊,但其他诊断结果也可能提示该病。先进的成像技术常用于辅助人类肠淋巴管扩张症的诊断,但在犬类中尚未进行充分研究。人类和犬类的治疗策略有所不同。饮食调整是人类治疗的主要手段,偶尔采用其他药物治疗,由于缺乏公认的免疫发病机制,很少使用免疫抑制剂。相比之下,皮质类固醇和免疫抑制疗法在犬类肠淋巴管扩张症中更常用。本综述旨在更好地了解犬类肠淋巴管扩张症,重点关注近期发现、比较方面以及未来必要的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc5a/9597800/31e0df5b53a3/animals-12-02791-g001.jpg

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