Krugman L, Bryan J N, Mealey K L, Chen A
Department of Veterinary Clinical Sciences, Washington State University, Pullman, Washington, USA.
J Small Anim Pract. 2012 Mar;53(3):185-7. doi: 10.1111/j.1748-5827.2011.01155.x. Epub 2011 Nov 28.
A six-year-old, neutered, female collie was presented to an oncology specialty service after developing tetraparesis and self-mutilation that progressively worsened while receiving chemotherapy for lymphoma. Neurologic examination revealed ataxia, paresis and diminished conscious proprioception in all limbs with entire spinal reflexes. Magnetic resonance imaging of the brain and spinal cord was normal. Electromyography of the limbs ruled out a vincristine-induced peripheral neuropathy. Cerebrospinal fluid analysis and cerebrospinal fluid and serum testing for Neospora and Toxoplasma were normal. Results of MDR1 genotyping revealed that the dog was homozygous for the ABCB1-1Δ (MDR1) mutation. This clinical presentation strongly resembled the effects seen from inadvertent intrathecal administration of vincristine in humans. Dogs that are homozygous for the ABCB1-1Δ (MDR1) mutation should not receive standard dosages of chemotherapy drugs known to be eliminated by P-glycoprotein, the gene product of ABCB1. Testing for this mutation is strongly recommended before chemotherapy initiation for at-risk breeds.
一只六岁已绝育的雌性柯利犬，在因淋巴瘤接受化疗期间出现四肢轻瘫和自残行为，且病情逐渐恶化，随后被转诊至肿瘤专科。神经系统检查发现四肢共济失调、轻瘫，本体感觉减退，脊髓反射正常。脑部和脊髓的磁共振成像结果正常。四肢肌电图检查排除了长春新碱引起的周围神经病变。脑脊液分析以及脑脊液和血清中弓形虫和新孢子虫检测结果均正常。多药耐药基因1（MDR1）基因分型结果显示，该犬为ABCB1-1Δ（MDR1）突变纯合子。这种临床表现与人类无意鞘内注射长春新碱后的表现极为相似。ABCB1-1Δ（MDR1）突变纯合子的犬不应接受已知由P-糖蛋白（ABCB1基因产物）清除的化疗药物标准剂量。强烈建议在对有风险的品种开始化疗前进行该突变检测。
