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血小板减少症犬伴或不伴特发性免疫性血小板减少症的抗血小板抗体检测及动态变化。

Detection and dynamics of anti-platelet antibodies in thrombocytopenic dogs with and without idiopathic immune thrombocytopenia.

机构信息

Colorado State University, Fort Collins, Colorado.

出版信息

J Vet Intern Med. 2020 Mar;34(2):700-709. doi: 10.1111/jvim.15737. Epub 2020 Feb 18.

Abstract

BACKGROUND

Antiplatelet antibodies are detected in multiple diseases including primary immune thrombocytopenia (ITP). Dynamics of how these antibodies change over time in ITP is unknown in dogs.

HYPOTHESIS/OBJECTIVES: Antiplatelet antibodies (APA) will be detected in thrombocytopenic dogs with multiple etiologies and dynamics of APA in dogs with ITP can be used to evaluate response to treatment and relapse. Determine APA at the time of diagnosis in thrombocytopenic dogs and serially in primary ITP dogs.

ANIMALS

Seventy-nine thrombocytopenic dogs and 28 primary ITP dogs.

METHODS

Direct flow cytometry was performed in thrombocytopenic dogs at initial evaluation and serially in suspected primary ITP dogs. In primary ITP dogs, a 2-tailed Fisher's exact test was performed comparing survival to discharge between dogs with and without melena and to relate response to treatment and relapse to changes in APA and platelet count (repeated measures analysis, Spearman correlation).

RESULTS

Twenty percent (16/79) of thrombocytopenic non-ITP dogs with infectious, neoplastic, or other diseases and all primary ITP dogs were positive for APA. Melena at initial evaluation was associated with decreased survival to discharge (odds ratio 0.06; P = .01). Persistence of APA was not associated with response to treatment, but recurrence of antibodies was associated with relapse (odds ratio 205.0; P < .01). There was no difference in percentage of APA or platelet count at initial diagnosis between dogs that did or did not respond to treatment.

CONCLUSIONS AND CLINICAL IMPORTANCE

Serial monitoring of APA in dogs with primary ITP appeared beneficial for determining relapse of disease.

摘要

背景

抗血小板抗体在包括原发性免疫性血小板减少症(ITP)在内的多种疾病中被检测到。这些抗体在 ITP 中随时间的变化动态在犬中尚不清楚。

假设/目的:将在具有多种病因的血小板减少症犬中检测到抗血小板抗体(APA),并可使用 ITP 犬中的 APA 动力学来评估对治疗的反应和复发。确定血小板减少症犬诊断时和原发性 ITP 犬的 APA 系列。

动物

79 只血小板减少症犬和 28 只原发性 ITP 犬。

方法

在初始评估时对血小板减少症犬进行直接流式细胞术,并对疑似原发性 ITP 犬进行连续检测。在原发性 ITP 犬中,对有和无黑便的犬进行生存至出院的双侧 Fisher 确切检验,并将对治疗的反应和复发与 APA 和血小板计数的变化相关联(重复测量分析,Spearman 相关)。

结果

20%(16/79)患有感染性、肿瘤性或其他疾病的非 ITP 血小板减少症犬和所有原发性 ITP 犬的 APA 均为阳性。初次评估时出现黑便与生存至出院的几率降低相关(优势比 0.06;P =.01)。APA 的持续存在与治疗反应无关,但抗体的复发与复发相关(优势比 205.0;P < .01)。在治疗反应良好或不佳的犬中,APA 的百分比或血小板计数在初次诊断时无差异。

结论和临床意义

对原发性 ITP 犬进行 APA 的连续监测似乎有利于确定疾病的复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbd4/7096660/cf278805e30c/JVIM-34-700-g001.jpg

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