Feline lymphoplasmacytic gingivostomatitis: Clinical and anatomopathological aspects

Abstract

Background: Feline lymphoplasmacytic gingivostomatitis (FLPG) is an idiopathic, multifactorial and highly challenging condition, since the results of the available treatments are partial and transitory. A set of lesions triggered by inflammatory reaction is observed, sometimes with ulcerations in the oral mucosa, leading to algia and discomfort. Histopathological examination figures as the definitive diagnostic tool, presenting distinct cellular elements. The present study aims to report three cases of FLPG, firstly addressing the anatomopathological findings, as well as the therapeutic approach used and the results obtained in each case. Cases: Case 1- Occurred in a feline Siamese male 15-year-old, weighing 3.8 kg, which was admitted at a local clinic, under the complaint of prostration, dysphagia, and weight loss, signs that were noticed approximately 5 days before. Clinical evaluation revealed multiple proliferative and ulcerative lesions, extending until the isthmus of the fauces, erythematous areas around the teeth and multifocal gingival reabsorption. Once the clinical signs and lesions were observed, samples were collected for histopathological examination and sent to the Laboratory of Animal Pathology (LAP) of Faculty of Agronomy and Veterinary Medicine of the University of Passo Fundo (FAVM-UPF). Histologically, both fragments presented lymphoplasmacytic infiltration, with large and intensely eosinophilic cytoplasm, often with granular aspect, central to lateralized hyperchromatic nuclei, located predominantly in lamina propria and mucosa, as well as a discrete Mott cell infiltrate. It was also observed the presence of diffuse suppurative chronic inflammatory infiltrate, predominantly in lamina propria and mucosa, as well as foci of edema and hemorrhage, in addition to loss of tissue architecture establishing the definitive diagnosis of FLPG. The tutor went to another veterinarian for a second opinion, but the patient died within four months. Case 2- Occurred in a no defined-breed male feline 7-year-old, weighing 3.9 kg, on complaint of hyporexia, inappetence, progressive thinning and greasy-looking fur. The tutor reported that the patient showed an increasing disinterest for offered feed, for approximately three weeks, but in recent days, consumption had declined dramatically. Clinical evaluation showed the same pattern of lesions in case 1, but with higher intensity, especially in the fauces area, as well as multifocal periodontal lesion and gingival retraction areas in several teeth. After the clinical signs and lesions were observed, samples were collected for histopathological examination and sent to the LAP of the FAVM-UPF, having the same diagnosis of case 1. The patient was submitted to a complete teeth extraction and, up to date, is asymptomatic, with a positive evolution. Case 3- Occurred in a no defined-breed female feline 6-year-old, weighing 4.1 kg, showing bleeding gums, reluctance to eat and mild halitosis, signs noticed around two weeks before. The patient was submitted to clinical evaluation, with lesions that consisted of erythematous areas, more evident in molar teeth, as well as ulcerated foci of the oral mucosa. Samples were collected for histopathological examination and sent to the LAP of the FAVM-UPF, with the same diagnosis as previous cases. The therapeutic approach used consisted of immunodulation and immunosuppression, using cyclosporin and prednisolone, respectively. Up to present, the patient shows control on severity of lesions, maintaining a good life quality. Discussion: The present study observed that clinical and anatomopathological findings corroborate with those cited in the literature, with special emphasis on the presence of Mott cells as well as the marked lymphoplasmacytic infiltrate, common in all three cases. The results of chosen treatments showed variation in results, even with the individualization of the therapeutic approach in the three cases.