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犬胃泌素瘤:一个病例研究及治疗选择的文献综述

Canine gastrinoma: a case study and literature review of therapeutic options.

作者信息

Hughes S M

机构信息

Taranaki Veterinary Centre, PO Box 193, Stratford, New Zealand.

出版信息

N Z Vet J. 2006 Oct;54(5):242-7. doi: 10.1080/00480169.2006.36705.

Abstract

CASE HISTORY

A 6.2 kg, 8-year-old, spayed female Australian Terrier was presented with weight loss, inappetence, lethargy and a 2-day history of intermittent vomiting.

CLINICAL FINDINGS

The dog had cranial abdominal pain and there was melaena present on digital rectal examination. Haematology revealed a marked, acute leucogram.

DIAGNOSIS AND TREATMENT

Fasting serum gastrin levels were markedly elevated and gastrinoma was suspected. Treatment was initiated with omeprazole, ranitidine and sucralfate. The dog remained clinically normal for 26 months, at which time exploratory surgery was undertaken and the dog subsequently euthanised due to extensive metastases. Histopathology and immunocytochemistry confirmed the diagnosis of metastatic gastrinoma.

CLINICAL RELEVANCE

This is a rare condition infrequently reported. Although the number of cases treated with omeprazole are too few to draw firm conclusions, it would appear that proton pump inhibitors are useful and should be considered for cases of gastrinoma managed medically. Long-term prognosis is poor, and survival times range from 1 to 147 weeks. Many treatment options are discussed in the medical literature though not all are feasible in veterinary patients.

摘要

病例史

一只6.2千克、8岁、已绝育的雌性澳大利亚梗犬,出现体重减轻、食欲不振、嗜睡症状,并有2天间歇性呕吐病史。

临床检查结果

该犬有上腹部疼痛,直肠指检发现有黑粪症。血液学检查显示明显的急性白细胞象。

诊断与治疗

空腹血清胃泌素水平显著升高,怀疑患有胃泌素瘤。开始使用奥美拉唑、雷尼替丁和硫糖铝进行治疗。该犬临床症状正常持续了26个月,之后进行了探查性手术,随后因广泛转移而实施安乐死。组织病理学和免疫细胞化学检查确诊为转移性胃泌素瘤。

临床意义

这是一种罕见疾病,鲜有报道。虽然用奥美拉唑治疗的病例数量太少,无法得出确凿结论,但质子泵抑制剂似乎是有用的,对于药物治疗的胃泌素瘤病例应予以考虑。长期预后较差,生存时间为1至147周。医学文献中讨论了许多治疗方案,但并非所有方案在兽医患者中都可行。

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