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一只狗体内与利什曼病可能相关的脊髓髓内肿物。

Intramedullary spinal cord mass presumptively associated with leishmaniasis in a dog.

作者信息

José-López Roberto, de la Fuente Cristian, Pumarola Martí, Añor Sonia

机构信息

Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain., Fundació Hospital Clínic Veterinari, Facultat de Veterinària, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain.

出版信息

J Am Vet Med Assoc. 2014 Jan 15;244(2):200-4. doi: 10.2460/javma.244.2.200.

Abstract

CASE DESCRIPTION

A 9-year-old male Miniature Poodle was evaluated because of progressive severe right hemiparesis, right forelimb lameness, and signs of cervical pain.

CLINICAL FINDINGS

A low body condition score (2/9) and popliteal lymphadenopathy were detected. Results of a CBC, serum biochemical analyses, urinalysis, cytologic examination of bone marrow and popliteal lymph node aspirates, and serum ELISA were consistent with systemic leishmaniasis. Magnetic resonance imaging of the cervical spinal cord revealed an intramedullary mass extending from the caudal aspect of the C5 vertebral body to the C5-6 intervertebral disk space with a contrast medium-enhanced pattern that had 3 zones (central contrast medium-enhanced core, intermediate isointense zone, and peripheral contrast medium-enhanced ring). Surgical biopsy of the mass was performed by means of a right C5-6 dorsal hemilaminectomy. Results of PCR assays for detection of Leishmania DNA in CSF and tissue biopsy samples were positive.

TREATMENT AND OUTCOME

Treatment for systemic leishmaniasis was initiated. Two months later, body condition, neurologic signs, and gait of the dog had substantially improved; the dog had mild right forelimb paresis at that time. Results of follow-up MRI indicated resolution of the cervical spinal cord lesion. Four months after diagnosis, the dog's neurologic condition was stable.

CLINICAL RELEVANCE

To the authors' knowledge, this report is the first in which clinical findings, clinicopathologic data, and MRI characteristics of an intramedullary inflammatory spinal cord lesion presumptively attributable to leishmaniasis in a dog have been reported, and the first report of CNS leishmaniasis in a dog with MRI resolution and a successful clinical response to treatment.

摘要

病例描述

一只9岁雄性迷你贵宾犬因进行性严重右半身轻瘫、右前肢跛行和颈部疼痛症状接受评估。

临床发现

检测到身体状况评分较低(2/9)以及腘淋巴结病。全血细胞计数、血清生化分析、尿液分析、骨髓和腘淋巴结穿刺液的细胞学检查以及血清酶联免疫吸附测定结果均与系统性利什曼病相符。颈椎脊髓的磁共振成像显示,髓内肿块从C5椎体尾侧延伸至C5 - 6椎间盘间隙,造影剂增强模式有3个区域(中央造影剂增强核心、中间等信号区和外周造影剂增强环)。通过右侧C5 - 6背侧半椎板切除术对肿块进行手术活检。脑脊液和组织活检样本中检测利什曼原虫DNA的聚合酶链反应测定结果呈阳性。

治疗与结果

开始对系统性利什曼病进行治疗。两个月后,犬的身体状况、神经症状和步态有显著改善;此时犬有轻度右前肢轻瘫。后续磁共振成像结果显示颈椎脊髓病变消退。诊断后四个月,犬的神经状况稳定。

临床意义

据作者所知,本报告首次报道了一只犬髓内炎性脊髓病变的临床发现、临床病理数据和磁共振成像特征,该病变推测由利什曼病引起,也是首例犬中枢神经系统利什曼病经磁共振成像显示病变消退且对治疗有成功临床反应的报告。

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