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Intestinal Leiomyositis: A Cause of Chronic Intestinal Pseudo‐Obstruction in 6 Dogs

BACKGROUND: Intestinal leiomyositis is a suspected autoimmune disorder affecting the muscularis propria layer of the gastrointestinal tract and is a cause of chronic intestinal pseudo‐obstruction in humans and animals. OBJECTIVE: To characterize the clinical presentation, histopathologic features, a...

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Autores principales: Zacuto, A.C., Pesavento, P.A., Hill, S., McAlister, A., Rosenthal, K., Cherbinsky, O., Marks, S.L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913632/
https://www.ncbi.nlm.nih.gov/pubmed/26608226
http://dx.doi.org/10.1111/jvim.13652
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author Zacuto, A.C.
Pesavento, P.A.
Hill, S.
McAlister, A.
Rosenthal, K.
Cherbinsky, O.
Marks, S.L.
author_facet Zacuto, A.C.
Pesavento, P.A.
Hill, S.
McAlister, A.
Rosenthal, K.
Cherbinsky, O.
Marks, S.L.
author_sort Zacuto, A.C.
collection PubMed
description BACKGROUND: Intestinal leiomyositis is a suspected autoimmune disorder affecting the muscularis propria layer of the gastrointestinal tract and is a cause of chronic intestinal pseudo‐obstruction in humans and animals. OBJECTIVE: To characterize the clinical presentation, histopathologic features, and outcome of dogs with intestinal leiomyositis in an effort to optimize treatment and prognosis. ANIMALS: Six client‐owned dogs. METHODS: Retrospective case series. Medical records were reviewed to describe signalment, clinicopathologic and imaging findings, histopathologic diagnoses, treatment, and outcome. All biopsy specimens were reviewed by a board‐certified pathologist. RESULTS: Median age of dogs was 5.4 years (range, 15 months–9 years). Consistent clinical signs included vomiting (6/6), regurgitation (2/6), and small bowel diarrhea (3/6). Median duration of clinical signs before presentation was 13 days (range, 5–150 days). Diagnostic imaging showed marked gastric distension with dilated small intestines in 4/6 dogs. Full‐thickness intestinal biopsies were obtained in all dogs by laparotomy. Histopathology of the stomach and intestines disclosed mononuclear inflammation, myofiber degeneration and necrosis, and fibrosis centered within the region of myofiber loss in the intestinal muscularis propria. All dogs received various combinations of immunomodulatory and prokinetic treatment, antimicrobial agents, antiemetics, and IV fluids, but none of the dogs showed a clinically relevant improvement with treatment. Median survival was 19 days after diagnosis (range, 3–270 days). CONCLUSIONS AND CLINICAL IMPORTANCE: Intestinal leiomyositis is a cause of intestinal pseudo‐obstruction and must be diagnosed by full‐thickness intestinal biopsy. This disease should be considered in dogs with acute and chronic vomiting, regurgitation, and small bowel diarrhea.
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spelling pubmed-49136322016-06-22 Intestinal Leiomyositis: A Cause of Chronic Intestinal Pseudo‐Obstruction in 6 Dogs Zacuto, A.C. Pesavento, P.A. Hill, S. McAlister, A. Rosenthal, K. Cherbinsky, O. Marks, S.L. J Vet Intern Med SMALL ANIMAL BACKGROUND: Intestinal leiomyositis is a suspected autoimmune disorder affecting the muscularis propria layer of the gastrointestinal tract and is a cause of chronic intestinal pseudo‐obstruction in humans and animals. OBJECTIVE: To characterize the clinical presentation, histopathologic features, and outcome of dogs with intestinal leiomyositis in an effort to optimize treatment and prognosis. ANIMALS: Six client‐owned dogs. METHODS: Retrospective case series. Medical records were reviewed to describe signalment, clinicopathologic and imaging findings, histopathologic diagnoses, treatment, and outcome. All biopsy specimens were reviewed by a board‐certified pathologist. RESULTS: Median age of dogs was 5.4 years (range, 15 months–9 years). Consistent clinical signs included vomiting (6/6), regurgitation (2/6), and small bowel diarrhea (3/6). Median duration of clinical signs before presentation was 13 days (range, 5–150 days). Diagnostic imaging showed marked gastric distension with dilated small intestines in 4/6 dogs. Full‐thickness intestinal biopsies were obtained in all dogs by laparotomy. Histopathology of the stomach and intestines disclosed mononuclear inflammation, myofiber degeneration and necrosis, and fibrosis centered within the region of myofiber loss in the intestinal muscularis propria. All dogs received various combinations of immunomodulatory and prokinetic treatment, antimicrobial agents, antiemetics, and IV fluids, but none of the dogs showed a clinically relevant improvement with treatment. Median survival was 19 days after diagnosis (range, 3–270 days). CONCLUSIONS AND CLINICAL IMPORTANCE: Intestinal leiomyositis is a cause of intestinal pseudo‐obstruction and must be diagnosed by full‐thickness intestinal biopsy. This disease should be considered in dogs with acute and chronic vomiting, regurgitation, and small bowel diarrhea. John Wiley and Sons Inc. 2016 2015-11-26 /pmc/articles/PMC4913632/ /pubmed/26608226 http://dx.doi.org/10.1111/jvim.13652 Text en Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle SMALL ANIMAL
Zacuto, A.C.
Pesavento, P.A.
Hill, S.
McAlister, A.
Rosenthal, K.
Cherbinsky, O.
Marks, S.L.
Intestinal Leiomyositis: A Cause of Chronic Intestinal Pseudo‐Obstruction in 6 Dogs
title Intestinal Leiomyositis: A Cause of Chronic Intestinal Pseudo‐Obstruction in 6 Dogs
title_full Intestinal Leiomyositis: A Cause of Chronic Intestinal Pseudo‐Obstruction in 6 Dogs
title_fullStr Intestinal Leiomyositis: A Cause of Chronic Intestinal Pseudo‐Obstruction in 6 Dogs
title_full_unstemmed Intestinal Leiomyositis: A Cause of Chronic Intestinal Pseudo‐Obstruction in 6 Dogs
title_short Intestinal Leiomyositis: A Cause of Chronic Intestinal Pseudo‐Obstruction in 6 Dogs
title_sort intestinal leiomyositis: a cause of chronic intestinal pseudo‐obstruction in 6 dogs
topic SMALL ANIMAL
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913632/
https://www.ncbi.nlm.nih.gov/pubmed/26608226
http://dx.doi.org/10.1111/jvim.13652
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