Dipartimento di Biomedicina comparata e Alimentazione, Facoltà di Medicina Veterinaria, Università di Padova, Viale dell'università 16, Legnaro, Italy.
Vet Pathol. 2013 Sep;50(5):753-60. doi: 10.1177/0300985812459336. Epub 2012 Sep 6.
Canine visceral leishmaniasis frequently causes renal damage that leads to chronic kidney disease. Fifteen dogs seropositive for Leishmania were selected and biopsied before (T0) and 60 days later after (T1) treatment with a specific anti-Leishmania pharmacological agent. Various parameters were selected for evaluating the glomerular and tubulointerstitial damage. At T0, mesangioproliferative and membranoproliferative glomerulonephritis were observed in 6 dogs, chronic glomerulosclerosis in 5, and end-stage kidney in 3; renal tissue from 1 dog was within normal histologic limits. The most frequently observed ultrastructural changes were foot-process effacement, thickening of the basement membranes, and immune deposits. One dog had mesangial immune deposits at T1 that had not been present at T0, so the diagnosis was changed to mesangioproliferative glomerulonephritis. In dogs with end-stage kidney, the number of obsolescent glomeruli and cystic atrophied glomeruli was increased at T1. However, progression of the glomerular lesions was minimal in most dogs. Worsening of tubulointerstitial scores was evident in the dogs with the most severe lesions at the first biopsy. Progression of the tubulointerstitial damage was minimal in the mildly affected dogs, and the interstitial inflammation was abated. In conclusion, renal lesions can progress over a 60-day period in canine leishmaniasis. A longer period between the renal biopsies would be necessary to demonstrate more severe changes. In addition a specific anti-Leishmania treatment could have a significant effect in the early stages of the disease.
犬内脏利什曼病常导致肾脏损伤,进而引发慢性肾病。选取 15 只利什曼原虫血清阳性犬,在(T0)开始用特定抗利什曼原虫药物治疗前和 60 天后(T1)进行活检。选择了各种参数来评估肾小球和肾小管间质损伤。在 T0 时,6 只狗出现系膜增生性和膜增生性肾小球肾炎,5 只狗出现慢性肾小球硬化,3 只狗出现终末期肾病;1 只狗的肾组织在组织学上正常。最常观察到的超微结构变化是足突消失、基底膜增厚和免疫沉积物。1 只狗在 T1 时出现了 T0 时不存在的系膜免疫沉积物,因此诊断改为系膜增生性肾小球肾炎。在终末期肾病犬中,T1 时废弃肾小球和囊性萎缩肾小球的数量增加。然而,大多数狗的肾小球病变进展最小。在第一次活检时病变最严重的犬中,肾小管间质评分恶化明显。在轻度受影响的犬中,肾小管间质损伤的进展最小,间质炎症减轻。总之,犬利什曼病的肾脏病变可在 60 天内进展。为了显示更严重的变化,需要在两次肾活检之间延长时间。此外,在疾病的早期阶段,特定的抗利什曼原虫治疗可能会产生显著效果。