Bunch S E, Metcalf M R, Crane S W, Cullen J M
Department of Companion Animal and Special Species Medicine, North Carolina State University, College of Veterinary Medicine, Raleigh 27606.
J Am Vet Med Assoc. 1989 Dec 15;195(12):1748-53.
Pleural effusion and pulmonary thromboembolism were diagnosed in a dog with autoimmune hemolytic anemia. Clinical signs of tachypnea, then dyspnea in association with pleural effusion, developed after 10 days of immunosuppressive corticosteroid therapy (greater than 2 mg/kg of body weight/d, PO). The diagnosis of pulmonary thromboembolism was made tentatively on the basis of results of a radionuclide lung perfusion scan and was confirmed by exploratory thoracotomy and lung biopsy. Tachypnea and pleural effusion gradually resolved without specific treatment, and additional episodes of anemia or dyspnea have not been observed. The pathogenesis of these findings was suspected to be related to corticosteroid-induced thrombotic tendencies, persistent thrombocytosis (greater than 800,000 cells/microliters), and vascular injury caused by repeated jugular venous catheterization. Pulmonary thromboembolism should be considered in dogs that develop clinical signs of tachypnea and/or pleural effusion during administration of immunosuppressive dosages of corticosteroids.
一只患有自身免疫性溶血性贫血的犬被诊断出患有胸腔积液和肺血栓栓塞。在免疫抑制性皮质类固醇治疗（大于2mg/kg体重/天，口服）10天后，出现了呼吸急促的临床症状，随后因胸腔积液出现呼吸困难。肺血栓栓塞的诊断初步基于放射性核素肺灌注扫描结果，并通过开胸探查和肺活检得到证实。呼吸急促和胸腔积液在未进行特殊治疗的情况下逐渐缓解，且未观察到额外的贫血或呼吸困难发作。这些发现的发病机制被怀疑与皮质类固醇诱导的血栓形成倾向、持续性血小板增多（大于800,000个细胞/微升）以及反复颈静脉插管引起的血管损伤有关。在给予免疫抑制剂量皮质类固醇期间出现呼吸急促和/或胸腔积液临床症状的犬应考虑肺血栓栓塞。
