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7 岁西班牙水犬的自主神经丛炎症浸润致巨食管症。

Megaoesophagus associated to inflammatory infiltrate in the autonomous plexus in a 7-year-old Spanish Water Dog.

机构信息

Departamento de Anatomía y Anatomía Patológica Comparadas y Toxicología, UIC Zoonosis y Enfermedades Emergentes (ENZOEM), Universidad de Córdoba, Córdoba, Spain.

Clínica Veterinaria Deros, Montilla, Córdoba, Spain.

出版信息

BMC Vet Res. 2024 Nov 29;20(1):534. doi: 10.1186/s12917-024-04399-9.

Abstract

BACKGROUND

Megaoesophagus (ME), a disorder of the oesophagus characterized by diffuse oesophageal dilation and decreased peristalsis that may be congenital or acquired. Knowledge regarding the aetiology and prognosis for canine acquired ME is currently limited with most cases being idiopathic, which is a considerable problem to implement an appropriate treatment and a potential better prognosis.

CASE PRESENTATION

A 7-year-old, neutered, female Spanish Water Dog was evaluated for progressive weight loss, chronic vomiting and regurgitation. The patient did not present other clinical signs. The contrast radiography in the cervical zone revealed oesophageal dilation. Eventually, the endoscopy revealed a marked dilation of the oesophagus. A surgery was conducted to insert a gastrotomy feeding tube. Initially, the patient response to this treatment was positive. However, the vomiting and regurgitation reappeared after 8 days. Due to the grim prognosis the owners elected to euthanize the patient. Necropsy revealed severe oesophageal dilation. The histopathological evaluation revealed moderate erosive catarrhal oesophagitis and gastritis. The skeletal muscular layer of the oesophagus showed moderate angular atrophy of some muscular fibres and a severe infiltrate of lymphocytes with marked tropism to autonomous neuronal bodies, some of which showed severe degenerative changes with absence of Nissl corpuscles, pyknotic nuclei and eosinophilic cytoplasm. The immunohistochemical study revealed that the majority of the infiltrate surrounding neuronal bodies were CD3 + T cells. These findings are consistent with an immune-mediated megaoesophagus.

CONCLUSIONS

To the best of our knowledge, this is the first report describing a lymphoplasmacytic infiltrate surrounding the oesophageal myenteric plexus in an adult dog with no other clinical signs or other myopathies. With these results, the authors hope to raise awareness in the diagnostic of canine ME and include an immune-mediated cause that lean to the establishment of appropriate treatment and improve prognosis of this condition.

摘要

背景

巨食道症(ME)是一种食道疾病,其特征为弥漫性食道扩张和蠕动减少,可能是先天性的或后天获得的。目前,关于犬后天性 ME 的病因和预后的知识有限,大多数病例为特发性的,这是实施适当治疗和提高预后的一个重大问题。

病例介绍

一只 7 岁、已去势的雌性西班牙水犬因进行性体重减轻、慢性呕吐和反流而接受评估。该患者没有出现其他临床症状。颈部区域的对比放射检查显示食道扩张。最终,内窥镜检查显示食道明显扩张。进行了手术以插入胃造口喂养管。最初,患者对这种治疗反应良好。然而,在 8 天后,呕吐和反流再次出现。由于预后不佳,主人选择对患者实施安乐死。尸检显示严重的食道扩张。组织病理学评估显示中度糜烂性卡他性食管炎和胃炎。食道骨骼肌层显示一些肌纤维中度角状萎缩和淋巴细胞严重浸润,并有明显的自主神经元体嗜性,其中一些神经元体显示严重的退行性变化,缺乏尼氏小体、固缩核和嗜酸性细胞质。免疫组织化学研究显示,围绕神经元体的浸润多数为 CD3+T 细胞。这些发现与免疫介导的巨食道症一致。

结论

据我们所知,这是第一份描述成年犬无其他临床症状或其他肌病的食道肌间神经丛周围存在淋巴浆细胞浸润的报告。有了这些结果,作者希望提高对犬 ME 的诊断意识,并包括免疫介导的病因,这有助于制定适当的治疗方案并改善这种情况的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c621/11606076/ddd23302b8d4/12917_2024_4399_Fig1_HTML.jpg

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