March Philip A, Hillier Andrew, Weisbrode Steven E, Mattoon John S, Johnson Susan E, DiBartola Stephen P, Brofman Peter J
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA.
J Vet Intern Med. 2004 Jan-Feb;18(1):65-74. doi: 10.1892/0891-6640(2004)18<65:sndidw>2.0.co;2.
The clinical records of 11 dogs with histologically confirmed superficial necrolytic dermatitis (SND) and a history of phenobarbital (PB) administration (SND/PB) were evaluated retrospectively (1995-2002). Historical, clinical, clinicopathologic, ultrasonographic, and pathologic findings were compared with those in dogs with SND without prior PB exposure (SND/No PB; n = 9) and with those dogs with PB-associated hepatotoxicity without skin disease (PB/hepatotoxicity). Dogs in the SND/PB group accounted for 44% of all histologically confirmed cases of SND that were evaluated at The Ohio State University Veterinary Teaching Hospital between 1995 and 2002. Median age of dogs in the SND/PB group was 10 years, and median duration of PB therapy was 6 years. Mean alanine aminotransferase (ALT) activity was 239 U/L, and median duration of abnormally high ALT activity was 6.25 months before SND diagnosis. Plasma amino acid concentrations measured in 1 dog were severely decreased. Ultrasonographic findings of hypoechoic nodules with hyperechoic borders corresponded to pathologic findings of nodular areas of normal hepatic tissue surrounded by zones of collapsed parenchyma with vacuolated hepatocytes. Clinical, clinicopathologic, ultrasonographic, and pathologic features of SND/PB and SND/No PB were similar. PB-associated cirrhosis and overt hepatic failure were not features of SND/PB. Different pathogenic mechanisms might induce SND in dogs. Chronic administration of PB requires further examination as a potential risk factor for the development of SND.
对11只经组织学确诊为浅表性坏死性皮炎(SND)且有苯巴比妥(PB)用药史(SND/PB)的犬的临床记录进行了回顾性评估(1995 - 2002年)。将其历史、临床、临床病理、超声和病理检查结果与未接触过PB的SND犬(SND/未接触PB;n = 9)以及有PB相关性肝毒性但无皮肤病的犬(PB/肝毒性)进行比较。SND/PB组的犬占1995年至2002年在俄亥俄州立大学兽医教学医院评估的所有经组织学确诊的SND病例的44%。SND/PB组犬的中位年龄为10岁,PB治疗的中位持续时间为6年。平均丙氨酸转氨酶(ALT)活性为239 U/L,在SND诊断前ALT活性异常升高的中位持续时间为6.25个月。对1只犬测量的血浆氨基酸浓度严重降低。超声检查发现低回声结节伴高回声边界,对应于病理检查结果,即正常肝组织的结节区域被伴有空泡化肝细胞的实质塌陷区域所包围。SND/PB和SND/未接触PB的临床、临床病理、超声和病理特征相似。PB相关性肝硬化和明显的肝衰竭不是SND/PB的特征。不同的致病机制可能在犬中诱发SND。长期给予PB作为SND发生的潜在危险因素需要进一步研究。