McCallum Katie E, Constantino-Casas Fernando, Cullen John M, Warland James H, Swales Harry, Linghley Niamh, Kortum Andre J, Sterritt Alex J, Cogan Tristan, Watson Penny J
Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.
North Carolina State College of Veterinary Medicine, Raleigh, North Carolina.
J Vet Intern Med. 2019 Jan;33(1):141-150. doi: 10.1111/jvim.15340. Epub 2018 Nov 29.
Reports of chronic hepatitis in dogs caused by Leptospira spp. are confined to small case series. Fluorescence in situ hybridization (FISH) allows the identification of spirochetes in liver samples. Consequently, this technique may help elucidate the role of Leptospira spp. in cases of chronic hepatitis.
To describe cases of hepatic leptospirosis in dogs diagnosed by FISH and subsequent polymerase chain reaction (PCR) speciation, with the absence of clinically relevant renal involvement.
Ten client-owned dogs.
Retrospective case series from the University of Cambridge presented between 2013 and 2016 or cases consulted by telephone advice during this time period. Cases were selected based on histopathologically confirmed granulomatous hepatitis and leptospiral organisms identified by FISH and PCR speciation (Leptospira interrogans/kirschneri).
All cases had increased liver enzyme activities, and FISH in combination with PCR speciation-confirmed infection with L. interrogans/kirschneri. Four dogs underwent repeat liver biopsy, FISH and PCR speciation 4-15 months after initial presentation and doxycycline treatment with 1 dog undergoing repeat sampling at necropsy. Three dogs that underwent repeat biopsy remained positive for L. interrogans/kirschneri infection. Six dogs were alive at the time of manuscript preparation and 4 dogs were euthanized as a result of progressive liver disease.
The presence of hepatic leptospiral organisms may be associated with chronic granulomatous hepatitis without clinical evidence of renal involvement. Further studies are necessary to elucidate the etiological role of these organisms in the disease.
关于钩端螺旋体属引起犬慢性肝炎的报道仅限于小病例系列。荧光原位杂交（FISH）可用于识别肝脏样本中的螺旋体。因此，该技术可能有助于阐明钩端螺旋体属在慢性肝炎病例中的作用。
描述通过FISH及随后的聚合酶链反应（PCR）分型诊断出的犬肝钩端螺旋体病病例，且无临床相关的肾脏受累情况。
10只客户拥有的犬。
回顾性病例系列，来自2013年至2016年期间剑桥大学提交的病例，或在此期间通过电话咨询的病例。根据组织病理学确诊的肉芽肿性肝炎以及通过FISH和PCR分型鉴定出的钩端螺旋体生物（问号钩端螺旋体/克氏钩端螺旋体）选择病例。
所有病例的肝酶活性均升高，FISH结合PCR分型证实感染问号钩端螺旋体/克氏钩端螺旋体。4只犬在初次就诊和强力霉素治疗后4 - 15个月接受了重复肝活检、FISH和PCR分型，1只犬在尸检时接受了重复采样。3只接受重复活检的犬仍为问号钩端螺旋体/克氏钩端螺旋体感染阳性。在撰写本文时，6只犬存活，4只犬因进行性肝病而实施安乐死。
肝钩端螺旋体生物的存在可能与慢性肉芽肿性肝炎相关，而无肾脏受累的临床证据。需要进一步研究以阐明这些生物在该疾病中的病因学作用。
