Basrah Journal of Veterinary Research,Vol.15, No.3,2016
Proceeding of 5th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
52
CLINICAL AND LABORATORY STUDIES OF FACIAL
ECZEMA SYNDROME IN LOCAL SHEEP BREEDS OF BASRAH
GOVERNORATE
*Kamal M. Alsaad , *Hassanin.H.N.AL Autaish, **Jihad Abdulameer
Ahmed
*Department of internal and preventive medicine,**Department of pathology and
poultry diseases
College of Veterinary Medicine, University of Basrah, Basrah, Iraq
ABSTRACT
The study was carried out on 523 local sheep breeds of different ages and of both
sexes represents different herds, reared in different areas of Basrah governorate. Fifty
four(54) local sheep breeds were show different clinical sings including sings of
photosensitization, parakeratosis , alopecia, Intense itching ,swelling of ears, anorexia
and decreased milk production and twenty three(23) clinically healthy local sheep
breeds were considered as controls. The study was documented at late summer and
early autumn time / 2015. Complete clinical examinations had been applied to all
animals. Results indicated that diseased sheep show signs of anorexia, salivation,
decrease milk production in milking animals, transient diarrhea, hypotricosis specially
of face with irregular patches of wool looseness, Intense itching of different body
parts, signs of parakeratosis, swelling and dropping of ears, icteric mucous
membranes specially of eyes, furthermore, on clinical examinations diseased animals
show rapid abdominal respiration, tachycardia with strong heart beats, decrease
ruminal contractions and increase body temperature, moreover hematological
examinations show significant decrease in total RBC, Hb and PCV count reflecting
Macrocytic hypochromic anemia, moreover total leukocytes count were also
increased significantly due to increase lymphocytes and eosinophiles. Data
concerning biochemical analysis revealed significantly decrease in total protein values
and zinc, whereas ALT.AST.ALP. Total and direct bilirubine and GGT, were
significantly increased in diseased sheep compared with controls. Postmortem
examination of dead or slaughtered animals showed enlarged icteric liver and have a
marked lobular pattern with yellow white patches of necrotic lesions, However some
cases show atrophied and marked fibrosed liver, in addition, histopathological
examination of skin raveled hyperkeratosis, parakeratosis, acanthosis with vacuolated
keratinocytes and infiltration of mononuclear inflammatory cells mainly lymphocytes,
Basrah Journal of Veterinary Research,Vol.15, No.3,2016
Proceeding of 5th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
53
moreover keratinized epidermis of the skin indicated severe parakeratosis with thick
keratin deposition and infiltration of lymphocytes, however liver of dead or
slaughtered animals show severe fibrosis of portal region with presence of edematous
fluid around bile duct and portal vasculatures were found congested, furthermore,
stenosis of bile duct due to hepatic fibrosis was detected with edematous fluids around
portal region included bile duct .It had been concluded that the results revealed that
the facial eczema syndrome was hepatogenic, light allergic eczema caused by toxic
hepatic dysfunctions and hepatonecrosis in grazing sheep in this area.
INTRODUCTION
Facial eczema or Pithomycotoxicosis is a disease of domesticated animals including
sheep, cattle and farmed deer’s of all ages, although it can affect other grazing
animals (1) Facial eczema may be defined as an acute obliterative cholangitis to
which all other changes are secondary (2), It had a significant impacts on animals
productivity, health and welfare and is considered as a common seasonal problem in
farm animals (3).
The condition is caused by ingestion of spores of the fungus Pithomyces chartarum,
which lives mainly on ryegrasses, however, under favorable conditions the fungus can
rapidly multiply in pastures (4). The spores of the fungus release a potent mycotoxin
known as sporidesmin in the gastrointestinal tract, which causes damage to the liver,
bladder and mammary glands(5). The sporidesmins are excreted through the biliary
system, in which they produce severe cholangitis and pericholangitis as a result of
tissue necrosis, in addition biliary obstruction may also indicated, which restricts
excretion of bile pigments and results in jaundice, similarly, failure to excrete
phylloerythrin in bile leads to photosensitization(6).
Facial eczema is named for the visible signs of photosensitisation that affect nonpigmented
areas of skin exposed to sunlight and result in severe skin irritation,
dermatitis and fly strike like lesions, however, in some outbreaks of the disease,
animals might show little or no visible skin lesions, but have suffered liver damage,
therefore the disease considered as not well named or misnomer (7).The toxic liver
injury commonly results in photodynamic dermatitis, since in sheep, the face is
mostly the only site of the body that is readily exposed to ultraviolet light(8).In live
animals, high levels of hepatic enzymes may reflect the extensive injury to the liver
Basrah Journal of Veterinary Research,Vol.15, No.3,2016
Proceeding of 5th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
54
(9).Production losses in dairy cattle and ewes arise from animal deaths, weight losses
or reduced weight gain, reduced milk yield and reproductive performance are more
findings common in this disease (10).In Basrah governorate little information's had
been documented concerning Facial Eczema syndrome in sheep, therefore the present
work were applied to study the clinical, hematological, biochemical and
histopathological characteristic properties of this disease.
MATERIALS AND METHODS
Study design
The study was carried out on 523 local sheep breeds of different ages and of both
sexes represents different herds, reared naturally in different areas of Basrah
governorate. Fifty four(54) local sheep breeds were show different clinical sings
including sings of photosensitization, parakeratosis, alopecia specially of face,
intense itching, swelling of ears, anorexia and decreased milk production in milking
ewes and twenty three (23) clinically healthy local sheep breeds were considered as
controls. The study were documented at late summer and early autumn time /2015.
Complete clinical examinations had been applied to all animals, moreover laboratory
examinations for detection of endo and/or ecto parasitic loud using usual laboratory
methods were also applied.
Blood collections and hematology
Ten milliliter (10ml) of blood were collected from each animal by jugular vein
drainage, (2.5) milliliter of blood mixed with EDTA were used to determine Total
erythrocyte count (TRBc), Hemoglobin concentration (Hb), packed cell volume
(PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin
concentration (MCHC) and total leukocytes count, (Hematology analyzer, Genex,
USA), furthermore differential leukocytes count were done using Giemsa stain
smears method according to Weiss and Wardrop (11). The remaining were used to
obtained serum for evaluation of Zinc, Alanine aminotrasferase (ALT),Aspartate
aminotrasfese (AST), Alkaline phosphatase (ALP),Total protein , Total bilirubin ,
Indirec and indirect bilirubin and Gamma glutamyltransferas (GGT), using available
kids from (Egyption company for biotechnology.S.A.E /Egypt).
Basrah Journal of Veterinary Research,Vol.15, No.3,2016
Proceeding of 5th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
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Gross post mortem examination and Histopathology
Some recently dead and /or slaughtered animals were examined for post mortem
examination and laboratory histopathological evaluations after owner’s approval. Skin
specimens were collected from the alopecic patches of skin and liver, fixed in 10%
neutral buffered formalin solution for 48 hrs, trimmed to apposite and suitable size,
washed then dehydrated and cleared in xylol, embedded in paraffin wax, after that it
were sectioned at 4-5 μ thickness, stained with hematoxyline and eosin, then
examined under a light microscope (12).
Statistical analysis were done and the significance of variations between infected and
healthy animals were evaluated through (SPSS) student t-test (13).
RESULTS
Diseased animals show signs of anorexia, salivation ,decrease milk production in
milking animals , Transient diarrhea ,Hypotricosis specially of face with irregular
patches of wool looseness, Fig (1), intense itching of different body parts Fig(2),Signs
of parakeratosis, Fig (3), Since different area of skin become thickened, wrinkling
with dandruff, swelling and dropping of ears ,Icteric mucous membranes specially of
eyes ,Furthermore on clinical examinations diseased animals show rapid abdominal
respiration ,tachycardia with strong heart beats , decrease ruminal contractions in
active ruminant animals and increase body temperature (Table 1.and 2) .
…..
Fig 1: Hypotricosis specially of face with irregular patches of wool looseness
Basrah Journal of Veterinary Research,Vol.15, No.3,2016
Proceeding of 5th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
56
Fig 2: Intense itching of different body parts
Fig 3: Signs of Hyperkeratosis and parakeratosis
Table 1: Clinical signs of diseased sheep with Facial eczema syndrome
Clinical signs Diseased sheep
n=54
%
Anorexia 49 90
Salivation 12 22.22
Decrease milk production in milking animals 34 63
Transient diarrhea 22 40.7
Hypotricosis specially of face 45 83.33
Intense itching of different body parts 41 76
Signs of parakeratosis 39 72.2
Swelling and dropping of ears 35 64.8
Icteric mucous membranes 29 53.7
On clinical examinations statistically significant increase (p<0.05) were encountered
in body temperature, respiratory and heart rates, However ruminal contractions was
decreased significantly (Table 2).
Basrah Journal of Veterinary Research,Vol.15, No.3,2016
Proceeding of 5th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
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Table 2: Body temperature, respiratory and heart rate, and ruminal contractions of diseased
sheep and controls.
Diseased sheep
n=54
Controls
n=23
Parameters
Body temperature C ° 39.12 ± 1.21 41.3 ±1.2 **
Respiratory rate/ mint 21.88 ±6.73 80.2 ±10.6 **
Heart rate/ mint 87.3 ±8.4 120.2 ±13.56**
Ruminal contractions / 5 mints 3.42± 1.22 1.28± 1.65**
Values are mean ± standard error of mean. ** (P<0.05).
Results of hematological examinations show significant decrease in total RBC , Hb
and PCV count reflecting Macrocytic hypochromic anemia ,Moreover total
leukocytes count were also increased significantly due to increase lymphocytes and
Eosinophiles.(Table 3).
Table 3: Blood parameters of diseased sheep and controls
Values are mean ± standard error of mean. ** (P<0.05).
Data concerning biochemical analysis revealed significantly decrease in total protein
values and zinc, whereas ALT.AST.ALP. Total direct, indirect bilirubine and GGT ,
were significantly increased in diseased sheep compared with controls (Table 4).
Diseased sheep
n=54
Controls
n=23
Parameters
RBC ×106 7.55± 1.23 4.83 ± 1.77 **
Hb g/dl 12.71 ± 2.66 7.39 ± 1.46 **
PCV % 32.53 ± 4.53 24.34 ± 4.67 **
MCV /fl 40.41 ± 4.55 52.39± 3.44 **
MCHC/dl 40.51 ± 7.77 29.43 ± 6.22 **
TLC ×103 9.76 ± 3.25 13.22 ± 4.54 **
Lymphocytes (Absolute) 4352 ± 321.53 7364 ± 553.34 **
Nutrophiles (Absolute) 4284 ± 162.21 4225.46 ± 593.13
Monocytes (Absolute) 542 ± 62 513 ± 219
Eosinophiles (Absolute) 452 ± 134 988 ± 147**
Basophiles (Absolute) 83 ± 65 87 ± 73
Basrah Journal of Veterinary Research,Vol.15, No.3,2016
Proceeding of 5th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
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Table 4: Biochemical parameters of diseased sheep and controls.
Diseased sheep
n=54
Controls
n=23
Parameters
Total protein (g/dl) 7.4± 1.23 5.3± 1.76**
ALT (U/L) 11.21± 2.34 22.51± 4.62
AST (U/L) 123± 11 228± 55**
ALP (U/L) 223±22 312±42**
Total bilirubine (mg/dl) 0.42±0.11 1.2± 0.24**
Direct bilirubine (mg/dl) 0.24± 0.11 0.9±0.12**
Indirect bilirubine ( mg/dl) 0.18± 0.13 0.32± 0.11**
GGT (U/L) 77± 6.44 256.23± 7.32**
Zinc (μg/ml) 76.56 ± 3.8 33.25± 5.48**
Values are mean ± standard error of mean. ** (P<0.05).
Postmortem examination of dead or slaughtered animals showed enlarged, icteric,
liver and have a marked lobular pattern with yellow white patches of necrotic lesions,
however in some cases show atrophied and marked fibrosed liver, In addition,
histopathological examination of skin raveled hyperkeratosis, parakeratosis,
acanthosis with vacuolated keratinocytes and infiltration of mononuclear
inflammatory cells mainly lymphocytes.Fig (4), Moreover keratinized epidermis of
the skin indicated severe parakeratosis with thick keratin deposition and infiltration of
lymphocytes. Fig (5). However livers of dead or slaughtered animals show severe
fibrosis of portal region with presence of edematous fluid around bile duct and portal
vasculature were found congested. Fig (6).Furthermore, stenosis of bile duct due to
hepatic fibrosis was detected with edematous fluids around portal region included bile
duct .Fig (7).Moreover other organs dose not show any gross or histopathological
changes .
Basrah Journal of Veterinary Research,Vol.15, No.3,2016
Proceeding of 5th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
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DISCUSSION
Facial eczema syndrome were suspected and recognized in Basrah governorate for the
first time ,Since there were no any scientific documents clarify and mention this
disease syndrome. In this mycotoxic disease of grazing livestock, the toxic liver injury
commonly results in photodynamic dermatitis (14).
Fig 4: Histopathology of skin of
diseased sheep with facial eczema
syndrome showed A. Hyperkeratosis B.
Parakeratosis C. Acanthosis with
vacuolated keratinocytes. D. Infiltration
of mononuclear inflammatory cells
mainly lymphocytes. H&E stain. 10X.
A
B
C
D
A
B
Fig 6: Histopathology of liver of dead
sheep with facial eczema syndrome
showed A. severe fibrosis of portal
region B. edematous fluids around bile
duct C. congested portal vasculatures.
H&E stain. 10X.
B A
C
Fig 7: Histopathology of liver of dead
sheep with facial eczema syndrome
showed A. severe fibrosis of portal
region and around bile duct caused
stenosis. B. edematous fluids around
portal region included bile duct. C.
inflammatory cells H&E stain. 40X.
A
B
C
Basrah Journal of Veterinary Research,Vol.15, No.3,2016
Proceeding of 5th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
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Facial eczema can have significant impacts on animal’s productivity, health and
welfare. Although the name suggests it is a skin disease, in most outbreaks most
animals in a herd show little or may be less visible skin lesions, but have suffered
liver damage. It is these animals that give the major economic impact (15).
Pastures tend to become toxic in late summer and autumn when periods of rain or
high humidity occur in combination with high night-time minimum temperatures,
However, to accurately predict Facial Eczema dangerous periods and take action to
prevent liver damage before it occurs, use of a pasture spore monitoring program is
essential (16).
Certain weather conditions are favorable to germination or sporulation, while ryegrass
pastures can provide adequate substrate for fungal germination all year round (a low
inoculum of P. chartarum spores over winter in Facial Eczema prone areas), the
greatest development of the funguses from mid-summer with the death of the pasture.
Late haymaking, topping or mowing of pastures may increase the substrate for fungal
growth and sporulation, increasing pasture toxicity potential, The extent of defoliation
during grazing largely determines intake of dead litter and spores very close grazing
will increase the uptake of spores(17).
In the current study diseased sheep show different clinical manifestations which were
in sporting data mention also by others (1,4,10), Mostly reflecting the photodynamic
dermatitis and hepatic injury, Since The clinical manifestations were characterized by
inflammatory edema in face (ears and eyelids) and even mandibular area. (Hepatic
photosensititsation)(3,6,8).
Sporidesmin is released from ingested spores in the upper digestive tract, absorbed
into the portal bloodstream and taken to the liver where it generates oxygen free
radicals which damage cell membranes(5 and 18), Furthermore concentration of
sporidesmin in the bile ducts lead to severe necrosis of their mucosal surfaces,
resulting in rapid reduction of biliary secretion, bile duct thickening and eventual
blockage, Cholangiohepatitis, ductular hyperplasia and fibrosis are also seen
histologically(16).The resulting pericholangitis leads to obstructive jaundice, which
reflected by the increase values of bilirubine (Total ,direct and indirect) in serum
indicated in this study.
It had been documented that Phylloerythrin, a normal breakdown product of
chlorophyll in the rumen, is normally absorbed into the portal bloodstream and
Basrah Journal of Veterinary Research,Vol.15, No.3,2016
Proceeding of 5th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
61
excreted by the liver in the bile, With the bile ducts blocked, it accumulates and spills
over into the bloodstream, The reaction between circulating phylloerythrin and
sunlight results in tissue damage (photosensitisation), and this is most severe in lightly
colored and non-pigmented skin such as on the face, ears, lips, vulva and udders
(15and 19).
Because of hepatic injury due to the disease condition specific biochemical changes
were indicated such as total protein and specific enzymes were also altered in there
activity, Therefore results of the present work raveled significant difference of most
of them, As well, blood serum concentrations of the enzyme gamma glutamyl
transferase (GGT) give the best indication of the severity of liver damage, or more
specifically, bile duct damage. Although GGT is synthesised by many tissues, blood
serum GGT originates mainly from the liver. Blood serum GGT activity principally
increases in cholestatic disease.
Facial eczema causes much higher GGT levels as indicated in this study (20). Serum
GGT concentrations may become elevated 2-3 weeks after exposure to sporidesmin
,Since the increase in serum GGT activity is proportional to the degree of
hepatobiliary damage, Moreover GGT levels drop gradually over a period of several
weeks after exposure to the toxin ceases, but often remain elevated for several months
(2 and 17 ).
Furthermore Zinc had a protective role for Facial Eczema , as it forms a complex with
sporidesmin, inhibiting its ability to cause cell damage, Since Facial Eczema
prevention using zinc can be effective if it maintains the animals blood serum zinc
level, Therefore feeding zinc oxide for example in grain/concentrates (in mash or
pelleted form) in the bail at milking can be very effective for prevention of disease
syndrome, However, the amount of zinc oxide included in each tone of grain
concentrate for prevention dosing must be carefully calculated to achieve, It were
indicated that diseased sheep in the current study were zinc deficient animals as the
required zinc/kg of live weight/day were minimize the risk of zinc deficiency
whereby decrease the prevalence of toxicity (21).
Results of gross examination of dead or slaughtered carcasses were agreed with (3
and 10) whom mentioned that severe icterus, hepatomegaly, enlarged gallbladder,
congestion of mesenteric vessels were the common necropsy findings.
Histopathological changes of the liver included necrosis of the hepatocytes,
Basrah Journal of Veterinary Research,Vol.15, No.3,2016
Proceeding of 5th International Scientific Conference,College of Veterinary Medicine
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62
cholangiohepatitis characterized by mononuclear inflammatory cell infiltrate in the
portal area and mild to severe fibrosis around bile ducts. (2 and 9).
دراسة سریریھ ومختبریھ لمتلازمة اکزیما الوجھ فی ضأن محافظة البصرة
*کمال الدین مھلھل السعد ،*حسنین ھشام ناصر العطیش و**جھاد عبدالامیر احمد
*فرع الطب الباطنی والوقائی **فرع الأمراض وأمراض الدواجن
کلیة الطب البیطری / جامعة البصرة
الخلاصة
ان ن قطع دد م ت ع ین، مثل لا الجنس ن ک ة وم ار مختلف ة بأعم أن المحلی ن الض ص 523 م ة فح ذه الدراس تم فی ھ
ت ریریة تمثل ات س ا علام ون منھ ع وخمس الأغنام والتی ترعى بصورة طبیعیة فی محافظة البصرة .أظھرت أرب
ین ی ح بالتحسس الضوئی ،نظیر التقرن ،الصلع،الحک الشدید،تورم الأذنین،فقدان الشھیة،وتناقص إنتاج الحلیب ف
ام ف ع یف وخری ی ص ة ف راء الدراس م اج یطرة ،ت ة س ریریا مجموع لیمة س ا س رون منھ لاث وعش دت ث ع
ا 2015 .أجریت جمیع الفحوصات السریریة اللازمة لکافة حیوانات الدراسة کما فحصت مختبریاً للتأکد من خلوھ
دان من إصابات الطفیلیات الداخلیة والخارجیة . تبین من نتائج الدراسة إن الأغنام المصابة بالمرض عانت من فق
ن ة م وف وبخاص اقط الص ھال، تس وب، اس اج الحل ی النع ب ف اج الحلی اقص إنت اب ، تن یلان اللع الشھیة التام ، س
دلی ورم وت رن، ت ة،علامات نظیرالتق الوجھ مکونة بقع جلدیة غیر منتظمة ،الحک الشدید فی مناطق الجسم المختلف
نفس ارع الت الأذنین، اصفرار الأغشیة المخاطیة وبخاصة المبطنة للعین وعند فحص الحیوانات سریریا لوحظ تس
م ألبطنی،ارتفاع معدلات ضربات القلب وقوتھا ،تناقص تقلصات الکرش مع ارتفاع معدلات درجات حرارة الجس
ر دم الحم ات ال ی لکری دد الکل دلات الع ی مع وی ف اقص معن ة تن ات الدموی رت الفحوص د أظھ ک فق ن ذل لا ع فض
م رة الحج ات کبی وع ذی الکری ،ترکیزخضاب الدم ومعدلات کریات الدم الحمر المرصوصة سبب فقر الدم من الن
ة ا اللمفی داد الخلای ة لأع ادة المعنوی بب الزی یض بس دم الب ا ال ی لخلای دد الکل اً الع ا ازداد معنوی باغ ،کم ة الص قلیل
ین ازدادت ی ح ک ف والحمضات، کما بینت نتائج الدراسة حدوث تناقص معنوی فی معدلات البروتین الکلی والزن
GGT رة دلات خمی ر ومع ر المباش والصفراوین الکلی والمباشر وغی ALT,AST,ALP معنویاً معدلات خمائر
د فرار الکب بالمقارنة مع مجموعة السیطرة کما اظھر التشریح المرضی للحیوانات المذبوحة أو النافقة تورم واص
ات اد لحیوان رت اکب ین ظھ ی ح ون ف اء الل ة بیض ع نخری ى بق واءه عل ع احت وظ م ی ملح وظھوره بمظھر تفصص
ة ع ملاحظ واک م رن، الش ر التق رن، نظی اخرى بشکل ضامر متلیف.کما تمثل الإمراض النسجی بظھور فرط التق
ة ة لادم ة المتقرن ت الطبق ک لوحظ تفجی الخلایا المتقرنة وارتشاح للخلایا الالتھابیة وبخاصة اللمفیة فضلا عن ذل
ة او ات النافق د الحیوان ی کب الجلد موشحة بالتقرن الشدید مع رواسب کیراتینیة ثخینة وارتشاح الخلایا اللمفیة اما ف
ة ان الاوعی فراء واحتق اة الص ول قن ة ح د الوذم ع تواج ابی م زء الب ف الج وحظ تلی د ل ابة فق المذبوحة جراء الاص
ول ة ح اح الوذم ع ارتش دی م البابیھ وبالاظافة إلى ذلک تم الکشف عن وجود تضیق القناة البابیھ بسبب التلیف الکب
رض و م أن ھ ی الض المنطقة البابیھ وبضمنھا قناة الصفراء . استنتج من ھذه الدراسة ان متلازمة اکزیما الوجة ف
Basrah Journal of Veterinary Research,Vol.15, No.3,2016
Proceeding of 5th International Scientific Conference,College of Veterinary Medicine
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ى کبدی المنشأ مع اکزیما تحسسیة خفیفة تسببت بوساطة اختلال الوظائف السمی مع نخر کبدی للأغنام التی ترع
فی ھذة المنطقة.
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Basrah Journal of Veterinary Research,Vol.15, No.3,2016
Proceeding of 5th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
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