脾脏白髓破坏的自然感染犬内脏利什曼病的严重临床表现。
Severe clinical presentation of visceral leishmaniasis in naturally infected dogs with disruption of the splenic white pulp.
机构信息
Fundação Oswaldo Cruz, Centro de Pesquisas Gonçalo Moniz, Salvador, Bahia, Brazil.
Centro de Referência em Doenças Endêmicas Pirajá da Silva (PIEJ), Jequié, Bahia, Brazil.
出版信息
PLoS One. 2014 Feb 3;9(2):e87742. doi: 10.1371/journal.pone.0087742. eCollection 2014.
In this work, we investigated the association between the disruption of splenic lymphoid tissue and the severity of visceral leishmaniasis in dogs. Clinical and laboratory data from 206 dogs were reviewed. Spleen sections collected during the euthanasia of these animals were analyzed, and the splenic lymphoid tissue samples were classified as well organized (spleen type 1), slightly disorganized (spleen type 2), or moderately to extensively disorganized (spleen type 3). Of 199 dogs with evidence of Leishmania infection, 54 (27%) had spleen type 1, 99 (50%) had spleen type 2, and 46 (23%) had spleen type 3. The number of clinical signs associated with visceral leishmaniasis was significantly higher in the animals with evidence of Leishmania infection and spleen type 2 or 3 than in the animals with spleen type 1. Alopecia, anemia, dehydration, dermatitis, lymphadenopathy, and onychogryphosis were all more frequent among animals with evidence of Leishmania infection and spleen type 3 than among the dogs with evidence of Leishmania infection and spleen type 1. The association between the severity of canine visceral leishmaniasis and the disorganization of the splenic lymphoid tissue was even more evident in the group of animals with positive spleen culture. Conjunctivitis and ulceration were also more common in the animals with spleen type 3 than in the animals with spleen type 1. The serum levels (median, interquartile range) of albumin (1.8, 1.4-2.3 g/dL) and creatinine (0.7, 0.4-0.8 mg/dL) were significantly lower and the serum levels of aspartate aminotransferase were significantly higher (57, 39-95 U) in animals with spleen type 3 than in animals with spleen type 1 (2.8, 2.4-3.4 g/dL; 0.9, 0.7-1.2 mg/dL and 23, 20-32 U, respectively). Our data confirm the hypothesis that disruption of the splenic lymphoid tissue is associated with a more severe clinical presentation of canine visceral leishmaniasis.
在这项工作中，我们研究了脾脏淋巴组织破坏与犬内脏利什曼病严重程度之间的关系。对 206 只狗的临床和实验室数据进行了回顾。对这些动物安乐死后采集的脾脏切片进行了分析，并将脾脏淋巴组织样本分为组织排列良好（脾脏 1 型）、轻度紊乱（脾脏 2 型）或中度至广泛紊乱（脾脏 3 型）。在 199 只具有利什曼原虫感染证据的犬中，54 只（27%）为脾脏 1 型，99 只（50%）为脾脏 2 型，46 只（23%）为脾脏 3 型。与内脏利什曼病相关的临床症状数量在具有利什曼原虫感染和脾脏 2 型或 3 型的动物中明显高于具有脾脏 1 型的动物。脱毛、贫血、脱水、皮炎、淋巴结病和爪变形在具有利什曼原虫感染和脾脏 3 型的动物中比具有利什曼原虫感染和脾脏 1 型的动物更常见。在脾脏培养阳性的动物中，犬内脏利什曼病的严重程度与脾脏淋巴组织紊乱之间的相关性更为明显。结膜炎和溃疡在脾脏 3 型动物中也比脾脏 1 型动物更常见。脾脏 3 型动物的血清白蛋白水平（中位数，四分位距）（1.8，1.4-2.3 g/dL）和肌酐水平（0.7，0.4-0.8 mg/dL）明显较低，天冬氨酸氨基转移酶水平明显较高（57，39-95 U），而脾脏 1 型动物的血清白蛋白水平（2.8，2.4-3.4 g/dL）和肌酐水平（0.9，0.7-1.2 mg/dL）和天冬氨酸氨基转移酶水平（23，20-32 U）。我们的数据证实了这样一种假设，即脾脏淋巴组织的破坏与犬内脏利什曼病更严重的临床表现有关。
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