Windsor R C, Sturges B K, Vernau K M, Vernau W
Veterinary Medical Teaching Hospital, University of California, Davis, CA 95616-8747, USA.
J Vet Intern Med. 2009 Mar-Apr;23(2):275-81. doi: 10.1111/j.1939-1676.2009.0276.x. Epub 2009 Feb 5.
Marked eosinophilic meningitis or meningoencephalomyelitis (EME) is rarely reported in dogs and the cause is usually undetermined. Long-term prognosis for dogs with cerebrospinal fluid (CSF) eosinophilia is variable.
Twenty-three client-owned dogs.
Retrospective case series. Dogs with eosinophilic CSF, defined as total nucleated cell count (TNCC) >3 cells/microL with >20% eosinophils, were identified by a computerized search of all dogs having cisternal and/or lumbar CSF analyzed as part of the diagnostic workup between 1992 and 2007.
TNCC in CSF ranged from 4 to 4,740 cells/microL (median 84 cells/microL, reference range <or=3 cells/microL), with 22 to 95% (median 78%) eosinophils in the differential count. An infectious agent was identified on necropsy in 4 of 23 (17%) dogs (Cryptococcus neoformans [n = 2], Neospora caninum [n = 1], and Baylisascaris procyonis [n = 1]). Each of these dogs had progressive neurologic deterioration. Sixteen dogs had idiopathic EME. Magnetic resonance imaging (MRI) findings were abnormal in 7 of 13 dogs with EME; 2 dogs had focal lesions and 5 dogs had multifocal lesions. Clinical signs in 12 of 16 (75%) dogs with idiopathic EME resolved with prednisone treatment. Three dogs with acute intervertebral disc herniations recovered after decompressive surgery alone.
Idiopathic EME is a common cause of eosinophilic pleocytosis in dogs. MRI findings are variable. Infectious causes of EME were less common and had a poor prognosis.
犬类中显著的嗜酸性脑膜炎或脑膜脑脊髓炎(EME)鲜有报道,病因通常不明。脑脊液(CSF)嗜酸性粒细胞增多的犬类长期预后各不相同。
23只客户拥有的犬。
回顾性病例系列研究。通过计算机检索1992年至2007年间作为诊断检查一部分而进行了脑室和/或腰椎脑脊液分析的所有犬,确定脑脊液嗜酸性粒细胞增多的犬,即总核细胞计数(TNCC)>3个细胞/微升且嗜酸性粒细胞>20%。
脑脊液中的TNCC范围为4至4740个细胞/微升(中位数84个细胞/微升,参考范围≤3个细胞/微升),分类计数中嗜酸性粒细胞占22%至95%(中位数78%)。23只犬中有4只(17%)在尸检时发现感染病原体(新型隐球菌[n = 2]、犬新孢子虫[n = 1]和浣熊贝蛔虫[n = 1])。这些犬均出现进行性神经功能恶化。16只犬患有特发性EME。13只患有EME的犬中有7只磁共振成像(MRI)结果异常;2只犬有局灶性病变,5只犬有多灶性病变。16只患有特发性EME的犬中有12只(75%)的临床症状经泼尼松治疗后缓解。3只患有急性椎间盘突出症的犬仅在减压手术后康复。
特发性EME是犬脑脊液嗜酸性粒细胞增多的常见原因。MRI结果各不相同。EME的感染性病因较少见且预后不良。