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Serum bile acid concentrations, histopathological features, and short-, and long-term survival in horses with hepatic disease.

AbstractBACKGROUND:
Serum bile acid concentrations (SBA) and a histopathological biopsy score [Equine Vet J 35 (2003) 534] are used prognostically in equine hepatic disease.
HYPOTHESIS:
Histopathologic features and scores, but not SBA, differ between survivors and nonsurvivors and correlate with histopathologic evidence of hepatic inflammation and fibrosis.
ANIMALS:
Retrospective study. Records (1999-2011) of horses with hepatic disease diagnosed by biopsy and with concurrent measurements of SBA.
METHODS:
Retrospective cohort study. Biopsies were examined for inflammatory cell infiltration including type and distribution, fibrosis, irreversible cytopathology affecting hepatocytes, hemosiderin, or other pigment deposition and bile duct proliferation. SBA, histopathological findings and a histological score [Equine Vet J 35 (2003) 534] were compared between short- (survival to discharge) and long-term (>6 months) survivors and correlations between SBA and histopathological findings investigated.
RESULTS:
Of 81 cases 90% survived short-term and 83% long-term. Short-term and long-term nonsurvival were associated with SBA (P = .009; P = .006), overall (P = .001; P = .002) and parenchymal (short-term only; P = .01) inflammation, portal and bridging fibrosis (all P < .001), apoptosis or single cell necrosis (P < .001; P = .008), hemosiderin deposition in hepatocytes (P = .011; P = .028), biliary (both P < .001), vascular (P = .003; P = .045) and endothelial (P < .001; P = .02) hyperplasia, nucleic changes (P = .004; P < .001) and the histopathological score (both P < .001). SBA were significantly and positively correlated with overall (P = .001), parenchymal (P < .001) and portal (P = .004) inflammation and portal (P = .036) and bridging (P = .002) fibrosis.
CONCLUSIONS AND CLINICAL IMPORTANCE:
SBA, histopathological findings and scores differ between survivors and nonsurvivors. SBA concentrations are associated with inflammation and fibrosis suggesting interference with hepatic function. A histopathological score >2 and, less so, SBA >20 μmol/L are specific but not sensitive indicators of nonsurvival.
AuthorsB Dunkel, S A Jones, M J Pinilla, A K Foote
JournalJournal of veterinary internal medicine (J Vet Intern Med) 2015 Mar-Apr Vol. 29 Issue 2 Pg. 644-50 ISSN: 1939-1676 [Electronic] United States
PMID25818219 (Publication Type: Journal Article)
CopyrightCopyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Chemical References
  • Bile Acids and Salts
Topics
  • Animals
  • Bile Acids and Salts (blood)
  • Biopsy (veterinary)
  • Horse Diseases (blood, pathology)
  • Horses
  • Liver Diseases (blood, pathology, veterinary)
  • Retrospective Studies
  • Survival Analysis

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