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Abstract Background: Bovine campylobacteriosis is a venereal disease due to infection with Campylobacter fetus venerealis. It causes mainly reproductive failures that lead to considerable economic losses. Objective: To perform a histopathological description of the mucosa from reproductive organs of heifers experimentally infected with Campylobacter fetus venerealis. Methods: Twelve 15-18-months-old Aberdeen Angus heifers were treated for estrous synchronization and exposed to natural breeding. They were then randomly divided into two groups: group A (n=9) was inoculated with C. fetus venerealis; group B (n=3, control) was inoculated with a placebo. Ultrasonography was performed at days 29, 38, and 42 post-breeding, and plasmatic progesterone levels were quantified using ELISA to confirm pregnancies. Animals in group A with plasma progesterone levels below 1 ng/mL and/or diagnosed as non-pregnant were further divided into three subgroups: A1 (n=4), euthanized at day 30 post-breeding; A2 (n=3), euthanized at day 40 post-breeding and A3 (n=2), euthanized at day 55 post-breeding. Heifers from group B, all diagnosed as pregnant, were euthanized each at day 30, 40, and 55 days post-breeding as well. Histological sections from every group were taken from oviducts, uterus, and vagina. Results: Lymphocytic inflammation was the most common lesion in all infected heifers. Trophoblast cells were found in the non-pregnant heifers euthanized at days 40, and 55 post-breeding. The inflammatory process with the presence of lymphoid cells probably altered the balance in the activity of maternal lymphoid cells, as well as gene expression of the trophoblast, finally affecting the embryo survival. Conclusion: This work contributes to the understanding of the histopathological process involved in post-mating infection of Campylobacter fetus bovine.
Resumen Antecedentes: La campilobacteriosis bovina es una enfermedad venérea causada por el Campylobacter fetus venerealis, que produce principalmente fallas reproductivas ocasionando grandes pérdidas económicas Objetivo: Describir las características histopatológicas de la mucosa de órganos reproductores de vaquillonas infectadas experimentalmente con Campylobacter fetus venerealis. Métodos: Doce vaquillonas Aberdeen Angus (15 a 18 meses de edad) con celo sincronizado, recibieron servicio natural, e inmediatamente se dividieron aleatoriamente en dos grupos: A (n=9), inoculadas con Campylobacter fetus venerealis; B (n=3; control), inoculadas con placebo. El diagnóstico de preñez se realizó por ultrasonografía a los 29, 38 y 42 días post-servicio; los niveles plasmáticos de progesterona fueron determinados por ELISA. Las vaquillonas del grupo A con niveles de progesterona plasmáticos menores a 1 ng/mL y/o diagnosticadas no preñadas, fueron consideradas para eutanasia y divididas en tres subgrupos: A1-eutanasia día 30 (n=4); A2-día 40 (n=3); y A3-día 55 (n=2) post-servicio. Las vaquillonas del grupo B, diagnosticadas preñadas, fueron eutanasiadas a los 30, 40 y 55 días. Se tomaron muestras de oviductos, útero y vagina. Resultados: Se observó inflamación linfocitaria en la totalidad de muestras del grupo A. Células trofoblásticas fueron encontradas en muestras correspondientes a los grupos A2 y A3. Probablemente, el proceso inflamatorio alteró el equilibrio de las células linfoides maternas y la expresión génica del trofoblasto, afectando la supervivencia embrionaria. Conclusión: Este trabajo contribuye a la comprensión del proceso histopatológico involucrado en la infección poscoital por Campylobacter fetus bovino.
Resumo Antecedentes: A campilobacteriose bovina é uma doença venérea originada pelo Campylobacter fetus venerealis, quem produz principalmente falha reprodutiva e porém grandes perdas económicas. Objetivo: Descrever as características histopatológicas da mucosa dos órgãos reprodutores de novilhas infetadas no modo experimental com Campylobacter fetus venerealis. Métodos: Doze novilhas Aberdeen Angus de 15 até 18 meses com cio sincronizado, receberam serviço natural. Logo após, foram aleatóreamente separados em grupos: A (n=9) inoculados com Campylobacter fetus venerealis e grupo B (n=3; controle) inoculadas com um placebo. O diagnóstico da gestação foi realizado por ultrasom nos dias 29, 38 y 42 pós-serviço. Os níveis plasmáticos da progesterona foram determinados por ELISA. As novilhas do grupo A, com níveis plasmáticos de progesterona menores a 1 ng/mL e/ou diagnosticadas não grávidas, foram consideradas para eutanásia e foram divididas em três subgrupos: A1-eutanásia aos 30 dias pós- serviço (n=4); A2-dia 40 (n=3); A3-dia 55 (n=2). Foram realizada eutanásia ás novilhas do grupo B diagnosticadas prenhadas, aos 30, 40 e 55 dias e a amostragem de ovidutos, útero e vagina. Resultados: A presença de inflamação linfocitária foi observada na totalidade das amostras do grupo A. Foram achadas células trofoblásticas nas amostras correspondente aos grupos A2 e A3. Provavelmente, pelo processo inflamatório tenha sido alterado o equilíbrio das células linfoides maternas, assim também como a expressão gênica do trofoblasto, afetando a supervivência embrionária. Conclusão: Este trabalho contribue á compreensão do processo histopatologico na infecção com Campylobacter fetus bovino pós-acasalamento.
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Objective To report a case presented with atypical clinical and radiological appearance in the early stage and finally pathologically confirmed as chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids ( CLIPPERS) , aiming to improve the understanding of the disorder. Methods The clinical, imaging, laboratory and pathological features as well as treatment and prognosis of a pathologically confirmed CLIPPERS patient with repeated relapsing-remitting course and stepwise progression in nine years were retrospectively analyzed. Results There were five relapsing-remitting processes in total clinical course of nine years. The clinical and radiological appearance was atypical in the early stage. At the first attack, the patient presented with fever, headache, altered consciousness and epileptic seizure. In the following courses, the patient presented with ataxia, blurred vision and limb weakness. Brain MRI (2006-2009) showed multiple abnormal signals including supratentorial white matter, pons and cerebellum with patchy gadolinium enhancement. Treatment with steroids resulted in a favorable clinical and radiological improvement. The symptoms of this attack included limb weakness, blurred vision, dysdipsia and dysarthria. Physical examination showed cognitive dysfunction, multiple cranial nerves injuries and bilateral pyramidal signs. Brain MRI showed multiple abnormal signals involved pons and cerebellum predominantly as well as supratentorial white matter with punctate gadolinium enhancement peppering the pons and cerebellum. A characteristic predominantly T lymphocytic perivascular infiltration was seen on brain biopsy. Both the imaging and histological findings were consistent with the CLIPPERS features. High-dose steroids treatment was given and obvious clinical and radiological improvements were observed. After discharge, steroids were reduced slowly combined with the use of immunosuppressant to avoid relapse of the disorder. Conclusions There is heterogeneity in clinical manifestations of CLIPPERS with repeated relapsing-remitting course and imaging presentations are sometimes atypical in the early stage, which leads to the misdiagonsis and missed diagnosis. Distinctive pathology is the “gold standard” for definite diagnosis. The nosological position of CLIPPERS is still unclear. Repeated relapse-remitting leads to secondary cerebral atrophy and degeneration, with the risk of progressing to primary central nervous system lymphoma. Early and vigorous steroids treatment with continuing maintenance immunotherapy results in the decreased relapse and best long-term prognosis. The neurologist should strengthen the understanding of CLIPPERS for early correct diagnosis and treatment aiming to reduce the functional disability.
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Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a relapsing-remitting disorder for which steroid administration is a key to control the progression. CLIPPERS can exhibit radiological features similar to malignant lymphoma, whose diagnosis is confounded by prior steroid administration. We report a case of CLIPPERS accompanied by abnormal elevation of beta-2 microglobulin in the cerebrospinal fluid (CSF). A 62-year-old man started to experience numbness in all fingers of his left hand one year ago, which gradually extended to his body trunk and legs on both sides. Magnetic resonance imaging demonstrated numerous small enhancing spots scattered in his brain and spinal cord. CSF levels of beta-2 microglobulin were elevated; although this often indicates central nervous system involvement in leukemia and lymphoma, the lesions were diagnosed as CLIPPERS based on the pathological findings from a biopsy specimen. We emphasize the importance of biopsy to differentiate between CLIPPERS and malignant lymphoma because the temporary radiological response to steroid might be the same in both diseases but the treatment strategies regarding the use of steroid are quite different.