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Severe Biliary Hyperplasia Associated with Liver Fluke and gastrointestinal

helminthes Infection in an Adult Lama Alpaca in Nepal

Dr.Kedar Karki

M.V.St.Preventive Veterinary Medicine

Veterinary Officer

Parasitology UnitCentral Veterinary Laboratory Kathmandu Nepal

Abstract/Summery

An adult alpaca (Lama pacos) had a locally extensive area ofhepatic atrophy involving

the right lobe. Grossly, the atrophic lobe was light tan and firm and contained small,

raised, white to yellow, partially mineralized circular nodules predominantly at theperiphery of the atrophic tissue. Microscopically, viablehepatocytes were not present in

the atrophic area, and the tissueconsisted of diffuse biliary epithelial proliferation without

any evidence of nuclear or cellular atypia or the presence ofmitotic figures. The circular

mineralized nodules consisted

of granulomatous inflammation with intralesional parasiticova surrounded by fibrous connective tissue. Morphologically, the ova were compatible

with those of Fasciola hepatica.Alongwith ova of Trichostorgylus spp,Cooperia

spp,Chabertia spp,Trichuris spp,Oesophagostomum spp was recorded from faeces ofLama Alpaca .The severebiliary hyperplasia was unusual, and it was not clear whetherit

was caused by an aberrant host response to the parasitic infection or whether it was an

unrelated event.

Key words: Alpacas; biliary hyperplasia; Fasciola hepatica;Lama Pacos; liver flukes,

Gastroinstinal helminthes, Nepal.

General background History:Although Alpaca Lama is not native to Nepal .Some foreigner had brought it from

Germany for personal interest for breeding out of 15 animal inherd.The affected animalwas an adult castrated male alpaca of unknown age .The carcass was in poor nutritional

state, and was ill since last week treated with routine antibiotics and supportive therapy

and died during course of treatment .On postmortem examination the most significantgross lesions were present in the liver. The right lobe of theorgan was markedly atrophic

(approximately 30% of normal size), light tan, and firm and contained numerous small

circular foci (up to 4 mm in diameter) on both the diaphragmatic and visceral surfaces.These foci were predominantly present at the periphery of the atrophic lobe and were

whiteto yellow and raised above the capsular surface, with firm tohard consistency. Cut

sections of these foci revealed partially

calcified material. Similar but fewer of these fociwere also seen in other parts of the liver .Multifocal irregularpale white foci wereobserved on the dorsal aspects of the diaphragmatic lung lobes. With about 40-50 adult

Fasciola parasite were present in bile duct.The circular nodules seen on gross

examination consisted ofa peripheral area of dense fibrous connective tissue surroundinga central region of partially mineralized cellular debris. Variable numbers of partially

degenerate parasitic ova were present inthe core of some of the nodules .The ova were

approximately 6090 x 130150 m and were morphologically compatible with ova of

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Fasciola hepatica.On Coprological examination of feaces from large and small intestine

revealed ova of Trichostorgylus spp,Cooperia spp,Chabertia spp,Trichuris

spp,Oesophagostomum spp was recorded.

Review of literatures:

Pathology of the liver is not a commonly recognized problem in South American

camelids, and only a limited number of etiologicagents are known to specifically affect

the liver in these species.Here, we describe locally extensive hepatic atrophy with diffusebiliary hyperplasia and multifocal granulomatous hepatitis associated with ova of liver

flukes in an alpaca (Lama pacos).

Although liver disease in South American camelids is not common,a number of examples

of hepatic pathology have been reported, including metabolic, toxic, infectious (parasitic,

bacterial,

fungal, viral), and neoplastic conditions. Among the parasitic

infections, liverflukes ( F. hepatica, F. gigantica), immature cysts of tapeworms (Echinococcusgranulosus, Taenia helicometra, T. hydatigena), and larval stages of nematodes( Lamanema chavezi) spp have been reported as etiologic agents.and ova of

Trichostorgylus spp,Cooperia spp,Chabertia spp,Trichuris spp,Oesophagostomum spp

also being causative agent of this condition.

F. hepatica infections have been identified in a wide rangeof species, including the cow,sheep, horse, goat, dog, cat, rabbit, guinea pig, squirrel, deer, beaver, pig, and human.

Fascioliasis has also been recognized in the llama and alpaca,both as a primary problem

and as an incidental infection.Although there are no published reports of liver flukes in

guanaco,

F. hepatica has been identified as a significant problem in

the phylogeneticallyrelated vicua in a semicaptiveresearch program in Argentina. Experimental infections in

the llama have demonstrated that the prepatent period of 812 weeks is similar to thatobserved in other species and thatuncontrolled infection can result in death.

F. hepatica is endemic in the area where the alpaca had resided.The clinical presentation

ofF. hepatica infections in SouthAmerican camelids is highly variable and quantitively

related to the level of infection. Animals infected with a low number of parasitesfrequently show no clinical evidence of disease,whereas heavily parasitized animals most

commonly present withsymptoms of anorexia and lethargy.

In South and North America, both acute and chronic forms of

liver fluke infections havebeen reported in these animals,although the chronic form is most commonly observed. Inthisform, the flukes cause blockage of bile ducts and incite extensive fibrosis in the liver.

In the affected alpaca, the findings were markedly different. The fibrotic response was

minimal in the area of biliary hyperplasia but was extensive around the areas ofgranuloma formation. The most prominent lesion was an extensive area of biliary

hyperplasia and multifocal granulomascontaining parasitic ova.

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The gross nodular lesions in the liver of this alpaca were alsosimilar to the lesions caused

by Lamanema chavezi, which is an important parasite in South American camelids that

has notbeen reported outside of South America.4Although grossly thehepatic lesions inanimals infected with L. chavezi are multifocal and partially calcified (similar to the

lesions in the affected alpaca), the microscopic findings are different (i.e., intralesional

parasitic ova are not seen within the partially calcified nodules).

Although the host response to the parasitic eggs was unusual, the parasitic ova in thisaffected alpaca were determined tobe those ofF. hepatica, and the strange liver tissue

reactionwas attributed to individual biologic variation of the alpaca. Some may argue that

the hyperplastic biliary change was the result of a blockage of a large bile duct, but nosuch lesion was identified at gross examination. Similarly, the hyperplasia could be

attributed to an unidentified hepatotoxic agent(s). However, the biliary hyperplasia was

confined to the right lobe,and the likelihood of toxins affecting a locally extensive areaofliver is remote.

Conclusion Recommendation:

Although Lama Alpaca is not native to Nepal there is very little information is available

regarding this species .Finding of this observation may be considered as reference for

disease and parasites of introduction of any exotic animal. A detail study in this regardshould be looked into

References

1.A. N. Hamir and B. B. Smith Brief Communications and Case Reports Severe

Biliary Hyperplasia Associated with Liver Fluke Infection in an Adult Alpaca Vet

Pathol 39:592-594 (2002) 2002 American College of Veterinary Pathologists

2.Anderson DE: Liver diseases of camelids. Proc North Am Vet Conf 1998:1053-

1054, 1998

3.Cafrune MM, Rebuffi GE, Gaido AB, Aguirre DH: Fasciola hepatica in semi-

captive vicuas (Vicugna vicugna) in northwest Argentina. Vet Rec 139:97, 1996

4.Cornic JL: Gastric squamous cell carcinoma and fascioliasis in a llama. Cornell Vet

78:235-241, 1988

5.Fowler ME: Unique parasitism of South American camelids in North and South

America. J Camel Pract Res 4:257-260, 1997

6.Fowler ME: Parasites. In: Medicine and Surgery of South American Camelids, pp195-230, Iowa State University Press, Ames, IA 1998

3

http://www.vetpathology.org/cgi/content/full/39/5/592#VETP-39-05-05-B4http://www.vetpathology.org/cgi/content/full/39/5/592#VETP-39-05-05-B4http://www.vetpathology.org/misc/terms.shtmlhttp://www.vetpathology.org/cgi/content/full/39/5/592#VETP-39-05-05-B4http://www.vetpathology.org/misc/terms.shtml

8/14/2019 Brief Communications and Case Report1

4/4

7.Hamir AN, Andreasen CB, Pearson EG: Endogenous lipid pneumonia (alveolar

histiocytosis) and hydrocephalus in an adult llama (Lama glama). Vet Rec 141:474-

476, 1997

8.Jones CT, Hunt RD, King NW: Diseases caused by parasitic helminths and

arthropods. In: Veterinary Pathology, pp 601-680, Williams & Wilkins, Baltimore,MD 1997

9.Puente GL: Acute and subacute fascioliasis of alpacas (Lama pacos) and treatmentwith triclabendazole. Trop Anim Health Prod 29:31-32, 1997

10.Rickard LG: Parasites. Vet Clin North Am Food Anim Pract 10:239-241, 1994

11.Rickard LG, Foreyt WJ: Experimental fascioliasis in llamas. J Helminthol Soc

Wash 59:140-144, 1992

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