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一只小猫的非尿毒症非致命性特发性钙质沉着症

Nonuraemic nonfatal idiopathic calciphylaxis in a kitten.

作者信息

Thom Nina, Er Elif, Reinacher Manfred

机构信息

Small Animal Clinic, Veterinary Faculty, Justus-Liebig-University, Frankfurter Straße 126, 35392, Giessen, Germany; Tierklinik Hofheim, Im Langgewann 9, 65719, Hofheim am Taunus, Germany.

出版信息

Vet Dermatol. 2013 Oct;24(5):547-e131. doi: 10.1111/vde.12064. Epub 2013 Aug 9.

Abstract

BACKGROUND

Calciphylaxis is a rare cutaneous disorder, characterized by vascular calcification and progressive skin necrosis, not yet described in cats. It is scarcely reported in animals, mostly due to iatrogenic or uraemic disturbances of the calcium-phosphate balance. In human patients, it is most commonly seen with end-stage renal disease, but several nonuraemic disorders, including inherited dysfunctions of tissue calcification inhibitors, have also been described.

HYPOTHESIS/OBJECTIVES: To describe a case of nonuraemic calciphylaxis in a cat.

ANIMALS

A 10-week-old male domestic short hair kitten was presented with hyperacute skin lesions. Initial dermatological signs were characterized by sharp demarcated erosions and ulcerations on the face, including the nasal planum and lips. Cutaneous lesions rapidly progressed into thick crusts with ulcerations, involving parts of the face and pinna as well as abdominal skin.

METHODS

Complete blood count, serum chemistry profile, urinalysis, parathyroid hormone measurement and histopathological examination of skin biopsies.

RESULTS

Histopathology from newly developed abdominal skin lesions revealed severe epidermal necrosis and calcification, multifocal pannicular calcification and calcified subcutaneous vessels, supporting a diagnosis of calciphylaxis. Treatment consisted of systemic and topical antimicrobials, analgesics, pentoxifylline, Lantharenol(®) , sodium thiosulfate and vitamin K. After initiation of therapy, no further progression was noticed; all medications could be discontinued eventually, and no relapse was seen in the following 2 years.

CONCLUSIONS AND CLINICAL IMPORTANCE

Calciphylaxis should be considered as a differential diagnosis for ulcerative cutaneous disorders in young cats. More information on this disease is needed to elucidate the pathomechanism.

摘要

背景

钙过敏是一种罕见的皮肤疾病,其特征为血管钙化和进行性皮肤坏死,猫中尚未见相关报道。在动物中鲜有报道,主要是由于医源性或尿毒症性的钙磷平衡紊乱。在人类患者中,最常见于终末期肾病,但也有几种非尿毒症性疾病被描述,包括组织钙化抑制剂的遗传性功能障碍。

假设/目的:描述一例猫的非尿毒症性钙过敏病例。

动物

一只10周龄的雄性家养短毛小猫出现超急性皮肤病变。最初的皮肤病学体征表现为面部包括鼻平面和嘴唇的界限清晰的糜烂和溃疡。皮肤病变迅速发展为伴有溃疡的厚痂,累及面部、耳廓部分以及腹部皮肤。

方法

全血细胞计数、血清生化分析、尿液分析、甲状旁腺激素测定以及皮肤活检的组织病理学检查。

结果

新出现的腹部皮肤病变的组织病理学检查显示严重的表皮坏死和钙化、多灶性脂膜炎钙化以及皮下血管钙化,支持钙过敏的诊断。治疗包括全身和局部使用抗菌药物、镇痛药、己酮可可碱、兰他洛尔(Lantharenol®)、硫代硫酸钠和维生素K。开始治疗后,未观察到进一步进展;所有药物最终均可停用,且在随后的2年中未见复发。

结论及临床意义

钙过敏应被视为幼猫溃疡性皮肤疾病的鉴别诊断之一。需要更多关于该疾病的信息来阐明其发病机制。

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