Brenner Karen, Pohlman Lisa, Muldowney Ian, Petersen Don, Schermerhorn Thomas
Department of Clinical Sciences, Kansas State University, Manhattan, KS, USA.
J Am Anim Hosp Assoc. 2013 Sep-Oct;49(5):329-32. doi: 10.5326/JAAHA-MS-5869. Epub 2013 May 20.
Extramedullary hematopoiesis (EMH) is the process by which normal blood cells are produced outside the bone marrow. In humans, EMH effusions are rare and are characterized by the presence of megakaryocytes, immature erythrocytes, immature leukocytes, or combinations of those cells. To the authors' knowledge, this is the first report to describe a case of peritoneal EMH effusion in a dog. A 5 yr old castrated male shorthaired dachshund presented with a 2 day history of pigmenturia and inappetence. A complete blood count revealed regenerative anemia with marked agglutination, spherocytosis, and an acute inflammatory leukogram characterized by a neutrophilia, regenerative left shift, and monocytosis. Ultrasound-guided aspiration of peritoneal effusion yielded a sample of high nucleated cellularity predominantly composed of mature and immature neutrophils and erythroid precursor cells. The patient was diagnosed with primary immune-mediated hemolytic anemia with concurrent EMH peritoneal effusion. The following case description and discussion explore the clinical findings associated with the unusual effusion and outline the possible pathogenesis by which the EMH effusion may have arisen in the dog.
髓外造血（EMH）是正常血细胞在骨髓外生成的过程。在人类中，EMH积液很少见，其特征是存在巨核细胞、未成熟红细胞、未成熟白细胞或这些细胞的组合。据作者所知，这是首例描述犬腹膜EMH积液病例的报告。一只5岁去势雄性短毛腊肠犬出现了2天的色素尿和食欲不振病史。全血细胞计数显示为再生性贫血，伴有明显凝集、球形红细胞增多，以及以中性粒细胞增多、再生性左移和单核细胞增多为特征的急性炎症性白细胞计数。超声引导下抽取的腹腔积液样本显示高核细胞性，主要由成熟和未成熟中性粒细胞以及红系前体细胞组成。该患者被诊断为原发性免疫介导性溶血性贫血并发EMH腹腔积液。以下病例描述和讨论探讨了与这种不寻常积液相关的临床发现，并概述了犬EMH积液可能产生的发病机制。
