Mathis Justin C, Yoo Seung H, Sullivan Lauren A
Department of Clinical and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.
J Vet Emerg Crit Care (San Antonio). 2014 Nov-Dec;24(6):739-44. doi: 10.1111/vec.12255.
To describe a novel bone marrow sampling technique utilized in a dog diagnosed with secondary dysmyelopoiesis.
A 1.5-year-old female spayed Lhasa Apso was treated for generalized seizures, aspiration pneumonia, and severe sepsis. Pertinent history included administration of phenobarbital (2.1 mg/kg PO q 12 h) for the 6 months prior to presentation for suspected idiopathic epilepsy. Initial leukopenia and thrombocytopenia was attributed to underlying sepsis and disseminated intravascular coagulation. Progressive decline in all cell lines (ie, leukopenia, thrombocytopenia, and anemia), along with history of phenobarbital administration, suggested myelodysplastic disease. Bone marrow cytology via serial costochondral rib aspirates confirmed secondary dysmyelopoiesis. Phenobarbital therapy was abruptly discontinued and replaced with alternative anticonvulsant therapy. Complete resolution of the observed leukopenia, thrombocytopenia, and anemia were observed 2 weeks after discontinuation of phenobarbital.
Costochondral rib aspirate appears to be a simple, viable method for bone marrow evaluation in dogs. Dysmyelopoiesis is a rare adverse effect of phenobarbital administration that can possess fatal consequences if not quickly recognized. Prompt diagnosis and discontinuation of the inciting drug is imperative to successful case management. Prognosis for return of bone marrow function appears good following drug discontinuation.
描述一种用于诊断为继发性骨髓生成异常的犬的新型骨髓采样技术。
一只1.5岁已绝育的拉萨犬因全身性癫痫发作、吸入性肺炎和严重脓毒症接受治疗。相关病史包括在因疑似特发性癫痫就诊前的6个月内服用苯巴比妥（2.1毫克/千克，口服，每12小时一次）。最初的白细胞减少和血小板减少归因于潜在的脓毒症和弥散性血管内凝血。所有细胞系（即白细胞减少、血小板减少和贫血）的进行性下降，以及苯巴比妥用药史，提示骨髓增生异常综合征。通过连续肋软骨穿刺进行骨髓细胞学检查证实为继发性骨髓生成异常。苯巴比妥治疗突然停止，改用替代抗惊厥治疗。停用苯巴比妥2周后，观察到白细胞减少、血小板减少和贫血完全缓解。
肋软骨穿刺似乎是犬骨髓评估的一种简单、可行的方法。骨髓生成异常是苯巴比妥给药罕见的不良反应，如果不能迅速识别，可能会产生致命后果。及时诊断并停用诱发药物对于成功的病例管理至关重要。停药后骨髓功能恢复的预后似乎良好。
