DiBartola S P, Tarr M J, Parker A T, Powers J D, Pultz J A
Department of Veterinary, Ohio State University, Columbus 43210.
J Am Vet Med Assoc. 1989 Aug 1;195(3):358-64.
The medical records of 59 dogs with renal amyloidosis were reviewed. Most dogs with amyloidosis were greater than 6 years old, and females were affected more often than males. Beagles, Collies, and Walker Hounds were at increased risk, whereas German Shepherd Dogs and mixed-breed dogs were at decreased risk. Common historical findings were anorexia, polyuria, polydipsia, lethargy, vomiting, and weight loss. Common laboratory findings were leukocytosis, lymphopenia, nonregenerative anemia, hypercholesterolemia, azotemia, hyperphosphatemia, metabolic acidosis, isosthenuria, cylindruria, and proteinuria. Proteinuria was moderate to severe in most dogs, as assessed by qualitative determination of urine protein concentration, urine protein/urine creatinine ratio, and 24-hour urine protein excretion. Conservative medical management was of little value, and survival ranged from 3 to 20 months in 12 dogs for which this information was available. Moderate to severe diffuse global glomerular amyloidosis was detected in all dogs. Medullary amyloid deposition was multifocal and less severe, but was evident in most dogs. Secondary tubulointerstitial and glomerular lesions were mild or absent in most dogs. Thromboembolism was identified in approximately 14% of affected dogs, underlying inflammatory disease in 37%, and neoplasia in 20%. Laboratory indicators of renal function correlated poorly with histologic lesions, with the exception of glomerular amyloid deposition and "chronic renal disease" index with endogenous creatinine clearance.
回顾了59只患有肾淀粉样变性病犬的病历。大多数患有淀粉样变性病的犬龄大于6岁,雌性比雄性更易患病。比格犬、柯利犬和沃克猎犬患病风险增加,而德国牧羊犬和混种犬患病风险降低。常见的病史表现为厌食、多尿、多饮、嗜睡、呕吐和体重减轻。常见的实验室检查结果为白细胞增多、淋巴细胞减少、非再生性贫血、高胆固醇血症、氮质血症、高磷血症、代谢性酸中毒、等渗尿、管型尿和蛋白尿。通过尿蛋白浓度定性测定、尿蛋白/尿肌酐比值和24小时尿蛋白排泄量评估,大多数犬的蛋白尿为中度至重度。保守药物治疗价值不大,12只可获得此信息的犬的存活时间为3至20个月。所有犬均检测到中度至重度弥漫性全球肾小球淀粉样变性。髓质淀粉样沉积为多灶性且程度较轻,但在大多数犬中明显。大多数犬的继发性肾小管间质和肾小球病变较轻或无病变。约14%的患病犬发现有血栓栓塞,37%有潜在炎症性疾病,20%有肿瘤。除肾小球淀粉样沉积和内源性肌酐清除率的“慢性肾病”指数外,肾功能实验室指标与组织学病变相关性较差。