Equis ISSN 2398-2977

Lung: multinodular fibrosis

Synonym(s): Equine multinodular pulmonary fibrosis (EMPF)

Contributor(s): Rachael Conwell, Nicola Menzies-Gow

Introduction

  • Cause: poorly understood type of interstitial pneumonia. Linked to equine herpes virus 5 (EHV-5) infection.
  • Signs: reported clinical signs include tachycardia, tachypnea, increased respiratory effort, cough, lethargy, fever, poor body condition and nasal discharge.
  • Diagnosis: thoracic radiography and ultrasonography reveal a sever diffuse nodular interstitial pattern. Histological examination of a lung biopsy specimen is required to make a definitive diagnosis.
  • Treatment: corticosteroids and possibly acyclovir.
  • Prognosis: the long-term prognosis is poor to guarded.

Pathogenesis

Etiology

  • Equine multinodular pulmonary fibrosis is a recently described fibrotic interstitial lung disease of horses that is associated with EHV-5 infection.

Pathophysiology

  • There is an association between the disease and EHV-5, although the pathogenesis of the condition is still unclear.
  • There is loss of functional pulmonary parenchyma due to extensive nodular to coalescing interstitial fibrosis. The remaining alveoli are lined by cuboidal epithalial cells and are filled with inflammatory cells.

Timecourse

  • The clinical signs have been present for days to weeks prior to presentation, although rare cases may present with acute respiratory distress.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Schwarz B, Schwendenwein I & van den Hoven R (2013) Successful outcome in a case of equine multinodular pulmonary fibrosis (EMPF) treated with valacyclovir. Equine Vet Educ 25 (9), 389-392 VetMedResource.
  • Wilkins P A (2013) Equine multinodular pulmonary fibrosis: Diagnosis and treatment. Equine Vet Educ 25 (9), 393-397 VetMedResource.
  • Schwarz B et al (2012) Concurrent T cell leukaemia and equine multinodular pulmonary fibrosis in a Hanoverian Warmblood mare. Equine Vet Educ 24 (4), 187-192 VetMedResource.
  • Dunkel B (2012) Pulmonary fibrosis and gammaherpesvirus infection in horses. Equine Vet Educ 24 (4), 200-205 PubMed.
  • Willimas K J, Maes R, Del Piero F et al (2007) Equine multinodular pulmonary fibrosis: a newly recognised herpesvirus-associated fibrotic lung disease. Vet Pathol 44 (6), 849-862 PubMed.
  • Wong D M, Belgrave R L, Williams K J et al (2008) Multinodular pulmonary fibrosis in five horses. JAVMA 232 (6), 898 PubMed.
  • Soare T, Leeming G, Morgan R et al (2011) Equine multinodular pulmonary fibrosis in horses in the UK. Vet Rec 169 (12), 313 PubMed.


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