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犬免疫介导性溶血性贫血和血小板减少症:对1979年至1983年在西部兽医学院诊断的55例病例的回顾性研究。

Immune-mediated Hemolytic Anemia and Thrombocytopenia in the Dog: A retrospective study of 55 cases diagnosed from 1979 through 1983 at the Western College of Veterinary Medicine.

作者信息

Jackson M L, Kruth S A

出版信息

Can Vet J. 1985 Aug;26(8):245-50.

Abstract

All recognized cases (n = 55) of immune-mediated hemolytic anemia and immune-mediated thrombocytopenia in dogs presented to the Western College of Veterinary Medicine from 1969 through 1983 were reviewed. Specific areas of concern were: association with other conditions, therapeutic response, prognosis, relapse rate and final outcome. Of these 55 cases, 19 were immune-mediated hemolytic anemia, 26 were immune-mediated thrombocytopenia and 10 were both immune-mediated hemolytic anemia and thrombocytopenia. Females were slightly over-represented and the mean age was 6.4 years. Therapy consisted of various combinations of immuno-suppressive drugs and in some cases, whole blood transfusion and splenectomy. No firm conclusions could be made regarding therapeutic efficacy, as a result of variation in treatment protocol and the occasional unavailability of follow-up data. Well over half of all cases were diagnosed as idiopathic. Precipitating factors or diseases most frequently implicated in secondary immune-mediated thrombocytopenia or hemolytic anemia were: recent vaccination, drug therapy, obstetrical complications, stress, recent viral infection and neoplasia. Twice as many cases of immune-mediated hemolytic anemia were seen in the cooler months (October to March), although this could not be related to antibody class or thermal reactivity. Immune-mediated thrombocytopenia both as a single disease and combined with immune-mediated hemolytic anemia had no seasonal incidence. History, clinical findings and hematological and clinical chemistry findings were consistent with data previously reported, with the exception of icterus, which appeared to be of higher incidence than most reports, being present in almost 50% of immune-mediated hemolytic anemia cases. Just over half of all dogs survived, although the survival rate was highest for immune-mediated hemolytic anemia, followed closely by immune-mediated thrombocytopenia and lowest for the combined disease. Immune-mediated thrombocytopenia most frequently ran a relapsing course requiring long-term or intermittent therapy.

摘要

回顾了1969年至1983年期间送至西部兽医学院的所有确诊的犬免疫介导性溶血性贫血和免疫介导性血小板减少症病例(n = 55)。关注的具体方面包括:与其他病症的关联、治疗反应、预后、复发率和最终结局。在这55例病例中,19例为免疫介导性溶血性贫血,26例为免疫介导性血小板减少症,10例同时患有免疫介导性溶血性贫血和血小板减少症。雌性病例略多,平均年龄为6.4岁。治疗包括免疫抑制药物的各种组合,在某些情况下还包括全血输血和脾切除术。由于治疗方案的差异以及随访数据偶尔不可用,因此无法就治疗效果得出确凿结论。超过一半的病例被诊断为特发性。继发性免疫介导性血小板减少症或溶血性贫血最常涉及的诱发因素或疾病为:近期接种疫苗、药物治疗、产科并发症、应激、近期病毒感染和肿瘤。在较凉爽的月份(10月至3月),免疫介导性溶血性贫血的病例数是其他月份的两倍,尽管这与抗体类别或热反应性无关。免疫介导性血小板减少症无论是单一疾病还是与免疫介导性溶血性贫血合并,均无季节性发病情况。病史、临床检查结果以及血液学和临床化学检查结果与先前报道的数据一致,但黄疸的发生率似乎高于大多数报道,几乎50%的免疫介导性溶血性贫血病例出现黄疸。所有犬中略多于一半存活,尽管免疫介导性溶血性贫血的存活率最高,其次是免疫介导性血小板减少症,而合并疾病的存活率最低。免疫介导性血小板减少症最常呈复发病程,需要长期或间歇性治疗。

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