Felis ISSN 2398-2950

Feline eosinophilic gastrointestinal sclerosing fibroplasia

Synonym(s): FGESF

Contributor(s): Michael Linton, Ed Hall

Introduction

  • Cause: unknown, suspected to be due to immune dysregulation, concurrent underlying disease.
  • Signs: weight loss, vomiting, +/- diarrhea, +/- lethargy, +/- over-grooming.
  • Diagnosis: histopathology + special stains to rule out other similar conditions.
  • Treatment: prednisolone, +/- antibiotics, +/- surgery.
  • Prognosis: may be good with early, appropriate therapy although data is limited.

Pathogenesis

Etiology

  • It is hypothesized that affected cats will suffer from immunological dysregulation possibly from predisposing factors.

Predisposing factors

General

  • General environmental, health or lifestyle factors:
    • Dietary causes, eg food allergy or intolerance Food hypersensitivity
    • Intestinal dysbiosis.
    • Previous foreign body ingestion, eg trichobezoar Stomach: gastric foreign body.
    • A history of over-grooming Psychogenic alopecia with potential of hair ingestion with associated allergens and other material may predispose to development of the disease.
    • Underlying gastrointestinal parasitic disease and fungi.
    • Underlying neoplasia - lymphoma Lymphoma has also been identified at the site of a FGESF lesion after mass excision. In that case it was unclear whether neoplasia was an unrelated comorbidity, causing unregulated inflammation and leading to a FGESF lesion, or that chronic inflammation actually led to the neoplasia. Thus, with our current knowledge, it is disputable whether neoplasia is a actually a predisposing factor.
    • Gastrointestinal disease alone is unlikely to be the sole trigger given then reported presence of non-gastrointestinal lesions.
  • Genetic predisposition.
  • The relationship is unclear, but a genetic predisposition is suspected given an increased observed incidence in Ragdolls.

Pathophysiology

  • Eosinophilic inflammation is a characteristic feature of this condition. Eosinophils will produce numerous mediators that can contribute to tissue destruction, eg major basic protein, transforming growth factor-beta and Interleukin-1 beta and Interleukin-6. This can result in tissue fibroplasia and fibrosis.  
  • These changes presumably lead to structural abnormalities leading to clinical signs specific to the location.
  • Factors such as secondary infection with bacterial, protozoal, fungal or viral agents are speculated to perpetuate the disease process due to a breach in gastrointestinal mucosal integrity and abnormal architecture.

Timecourse

  • Antecedent clinical signs have been noted up to 1 year prior to presentation.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Thieme M E, Olsen A M, Woolcock A D, Miller M A and Simons M C (2019) Diagnosis and management of a case of retroperitoneal eosinophilic sclerosing fibroplasia in a cat. JFMS Open Rep 5(2) PubMed.
  • Delrue B, Drut A, Gauthier G, Bertrand A and Fusellier M (2018) Cas de fibroplasie sclérosante éosinophilique duodénale chez un jeune chat européen Duodenal eosinophilic sclerosing fibroplasiain a young domestic shorthair: A case report.  Revue Vétérinaire 53 (4), 121-128.
  • Kambe N, Okabe R, Osada H, Ogawa M, Kishimoto M, Fukushima R, Kondo H and Ohmori K (2018) A case of feline gastrointestinal eosinophilic sclerosing fibroplasia limited to the mesentery. J Small Anim Pract Epub ahead of print PubMed.
  • Brloznik M, Faraguna S, Goc M and Svara T (2017) Recurrent feline gastrointestinal eosinophilic sclerosing fibroplasia and presumptive eosinophilic cystitis in a domestic short-haired cat: A case reportVeterinární medicína 62(5), 295-300.
  • Cho M J, Kim M C and Seo K W (2017) Feline gastrointestinal eosinophilic sclerosing fibroplasia in a Bengal cat. J Vet Clin 34 (6), 481-483.
  • Linton M, Nimmo J S, Norris J M, Churcher R, Haynes S, Zoltowska A, Hughes S, Lessels S, Wright M and Malik R (2015) Feline gastrointestinal eosinophilic sclerosing fibroplasia: 13 cases and a review of an emerging clinical entity. J Feline Med Surg  17 (5), 392-404 PubMed.
  • Grau-Roma L, Galindo-Cardiel I, Isidoro-Ayza M, Fernandez M, Majó N (2014) A case of feline gastrointestinal eosinophilic sclerosing fibroplasia associated with phycomycetes. J Comp Pathol 151 (4), 318-321.
  • Munday J S, Martinez A W and Soo M (2014) A case of feline gastrointestinal eosinophilic sclerosing fibroplasia mimicking metastatic neoplasia. N Z Vet J 62 (6), 356-360 PubMed
  • Eckstrand C D, Barr B C, Woods L W, Spangler T and Murphy B (2013) Nematode-associated intramural alimentary nodules in pumas are histologically similar to gastrointestinal eosinophilic sclerosing fibroplasia of domestic cats.  J Comp Pathol 148(4), 405-409 PubMed.
  • Suzuki M, Onchi M and Ozaki M (2013) A case of feline gastrointestinal eosinophilic sclerosing fibroplasia. J Toxicol Pathol 26 (1), 51-53 PubMed
  • Weissman A, Penninck D, Webster C, Hecht S, Keating J, Craig L E (2013) Ultrasonographic and clinicopathological features of feline gastrointestinal eosinophilic sclerosing fibroplasia in four cats. J Feline Med Surg 15(2),148-154 PubMed.
  • Gamble D A (2010) Letters to the editor and rebuttal regarding the paper recently published in Veterinary and Comparative Oncology, 'Feline intestinal sclerosing mast cell tumour: 50 cases (1997-2008) 2010; 8: 72-79' by C. H. C. Halsey, B. E. Powers and D. A. Kamstock. Letter to the editor #2. Vet Comp Oncol  8(3), 236-242 PubMed.
  • Halsey C H, Powers B E and Kamstock D A (2010) Feline intestinal sclerosing mast cell tumour: 50 cases (1997-2008). Vet Comp Oncol 8(1), 72-79 PubMed.
  • Schulman F Y and Lipscomb T P (2010) Letters to the editor and rebuttal regarding the paper recently published in Veterinary and Comparative Oncology, 'Feline intestinal sclerosing mast cell tumour: 50 cases (1997-2008) 8: 72-79. Vet Comp Oncol  8(3), 236-242 PubMed.
  • Craig L E, Hardam E E, Hertzke D M, Flatland B, Rohrbach B W and Moore R R (2009) Feline gastrointestinal eosinophilic sclerosing fibroplasia. 46 (1), 63-70 PubMed.

Other sources of information

  • Catro-Lopez J, Fernandez M, de Sousa A R (2012)  A case of feline gastrointestinal eosinophilic sclerosing fibroplasia associated with zygomytes fungi (abstract, ISFM Feline Congress, Budapest). J Fel Med Surg 14, 650.


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