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 Unit
Central Veterinary Laboratory Kathmandu Nepal

Abstract/Summery

An adult alpaca (Lama pacos) had a locally extensive area of hepatic 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 the
periphery of the atrophic tissue. Microscopically, viable hepatocytes were not present in
the atrophic area, and the tissue consisted of diffuse biliary epithelial proliferation without
any evidence of nuclear or cellular atypia or the presence of mitotic figures. The circular
mineralized nodules consisted of granulomatous inflammation with intralesional parasitic
ova 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 of
Lama Alpaca .The severe biliary hyperplasia was unusual, and it was not clear whether it
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 animal
was 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 significant
gross lesions were present in the liver. The right lobe of the organ 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
white to yellow and raised above the capsular surface, with firm to hard consistency. Cut
sections of these foci revealed partially calcified material. Similar but fewer of these foci
were also seen in other parts of the liver .Multifocal irregular pale white foci were
observed 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 of a peripheral area of dense fibrous connective tissue surrounding
a central region of partially mineralized cellular debris. Variable numbers of partially
degenerate parasitic ova were present in the core of some of the nodules .The ova were
approximately 60–90 x 130–150 µm 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 etiologic agents are known to specifically affect
the liver in these species. Here, we describe locally extensive hepatic atrophy with diffuse
biliary 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, liver
flukes (F. hepatica, F. gigantica), immature cysts of tapeworms (Echinococcus
granulosus, 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 range of 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 phylogenetically
related vicuña in a semicaptive research program in Argentina. Experimental infections in
the llama have demonstrated that the prepatent period of 8–12 weeks is similar to that
observed in other species and that uncontrolled infection can result in death.

F. hepatica is endemic in the area where the alpaca had resided. The clinical presentation
of F. hepatica infections in South American camelids is highly variable and quantitively
related to the level of infection. Animals infected with a low number of parasites
frequently show no clinical evidence of disease, whereas heavily parasitized animals most
commonly present with symptoms of anorexia and lethargy.

In South and North America, both acute and chronic forms of liver fluke infections have
been reported in these animals, although the chronic form is most commonly observed. In
this form, 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 of
granuloma formation. The most prominent lesion was an extensive area of biliary
hyperplasia and multifocal granulomas containing parasitic ova.

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The gross nodular lesions in the liver of this alpaca were also similar to the lesions caused
by Lamanema chavezi, which is an important parasite in South American camelids that
has not been reported outside of South America.4 Although grossly the hepatic lesions in
animals 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 this
affected alpaca were determined to be those of F. hepatica, and the strange liver tissue
reaction was 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 no
such 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 area of
liver 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 regard
should be looked into

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