Effects of therapeutic plasma exchange on serum immunoglobulin concentrations in a dog with refractory immune-mediated hemolytic anemia
| Autor: | Mark J. Acierno, Alyssa M. Scagnelli, Chin-Chi Liu, Stuart Walton |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
Hemolytic anemia medicine.medical_specialty 040301 veterinary sciences Anemia medicine.medical_treatment Splenectomy 030232 urology & nephrology Gastroenterology Pallor 0403 veterinary science 03 medical and health sciences Lethargy Dogs 0302 clinical medicine Internal medicine medicine Animals Dog Diseases Autoagglutination Plasma Exchange General Veterinary medicine.diagnostic_test business.industry 04 agricultural and veterinary sciences medicine.disease Capillary refill Immunoglobulin M Immunoglobulin G Vomiting Anemia Hemolytic Autoimmune medicine.symptom business |
| Zdroj: | Journal of the American Veterinary Medical Association. 252:1108-1112 |
| ISSN: | 0003-1488 |
| Popis: | CASE DESCRIPTION A 9-year-old 8.3-kg (18.3-lb) neutered male Miniature Schnauzer was referred for diagnosis and treatment of a sudden onset of lethargy, anorexia, vomiting, and pallor. CLINICAL FINDINGS On physical examination, the dog was lethargic with pale mucous membranes and a capillary refill time ≥ 2 seconds. Skin and sclera were mildly icteric. Signs of pain were elicited during abdominal palpation, and an enlarged spleen was noted. Results of agglutination testing and cytologic findings were consistent with immune-mediated hemolytic anemia (IMHA). No contributing factors for development of IMHA were identified. TREATMENT AND OUTCOME Initial treatment included management with immunosuppressant medications. Three packed RBC transfusions were administered, but clinical signs continued to progress. Therefore, therapeutic plasma exchange (TPE) was performed 5 and 9 days after admission. Following each TPE procedure, the dog had an appreciable clinical improvement and decrease in RBC autoagglutination, and the Hct stabilized. Serum IgG and IgM concentrations were measured during and after both TPE procedures. Despite anticoagulative treatment, the dog developed a thrombus in the splenic vein, necessitating a splenectomy. CLINICAL RELEVANCE The decrease and rebound in serum IgG and IgM concentrations following TPE provided evidence that TPE may have the same immunomodulatory effects in dogs as have been proposed to occur in people. Further, findings suggested that TPE may be a useful alternative in dogs with refractory IMHA when traditional treatments fail. |
| Databáze: | OpenAIRE |
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