Intestinal Crypt Lesions Associated with Protein‐Losing Enteropathy in the Dog

Abstract

Six dogs were diagnosed with protein losing enteropathy (PLE). There was no evidence of inappropriate inflammatory infiltrates or lymphangiectasia in multiple mucosal biopsies of the small intestine of 4 of the dogs. The 5th and 6th dogs had obvious lymphangiectasia and a moderate infiltrate of inflammatory cells in the intestinal mucosa. All 6 dogs had a large number of dilated intestinal crypts that were filled with mucus, sloughed epithelial cells, and/or inflammatory cells. Whether PLE occurs in these dogs because of protein lost from the dilated crypts into the intestinal lumen or whether the dilated crypts are a mucosal reaction due to another undetermined lesion that is responsible for alimentary tract protein loss is unknown. However, when large numbers of dilated intestinal crypts are present, they appear to be associated with PLE even if there are no other remarkable lesions in the intestinal mucosa.

Lymphatic deletion of calcitonin receptor–like receptor exacerbates intestinal inflammation

“…Mild (1) Moderate (2) Moderate high (3) Severe ( intestinal lymphatic insufficiency, with secondary complications of intestinal inflammation and protein-losing enteropathy, to our knowledge the Calcrl fl/fl /Prox1-CreER T2 mouse model represents the first and only model in the field from which we can begin to address these broader questions (19).…”

“…Collectively, these results suggest either that lymphatic insufficiency may be causative of IBDs or that incorrect lymphatic expansion and function can exacerbate the disease phenotype. Although there are some large animal models, including several inbred strains of dogs, that exhibit intestinal lymphatic insufficiency, development of genetically tractable animal model systems in which the causes and consequences of lymphatic insufficiency can be addressed in the context of inflammation initiation and progression is needed (3,19).…”

Effect of Tissue Processing on Assessment of Endoscopic Intestinal Biopsies in Dogs and Cats

“…7,12 Lymphangiectasia 13,14 and severe crypt lesions [15][16][17] in particular have been reported to be associated with protein-losing enteropathy (PLE). However, either the histopathologic finding or hypoalbuminemia was an inclusion criterion in most such studies, small numbers of animals were involved, or both.…”

“…However, either the histopathologic finding or hypoalbuminemia was an inclusion criterion in most such studies, small numbers of animals were involved, or both. For example, in the case of crypt lesions, there are only 9 animals represented by 3 studies [15][16][17] ; hence, it is not surprising that they all might be hypoalbuminemic. When the studies are larger and the inclusion criteria are much broader and all cases with chronic diarrhea seen over a specified time period are included and do not include hypoalbuminemia or these specific histologic lesions, the relationship is not obvious.…”

Serum concentrations of canine alpha1-proteinase inhibitor in cobalamin-deficient Yorkshire Terrier dogs

“…13,15,20 Clinical signs observed in Yorkshire Terriers with PLE include diarrhea, vomiting, weight loss, and ascites, and resemble signs present in dogs with PLE belonging to other dog breeds. 5,20 However, some clinical features, such as bicavitary effusion 14,24 (Craven M, Duhamel GE, Sutter NB, et al: 2009, Absence of bacterial association in Yorkshire terriers with protein-losing enteropathy and cystic intestinal crypts. J Vet Intern Med 23:757.…”