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慢性肾病致波斯猫尿毒症性脑病

Uraemic Encephalopathy in a Persian Cat with Chronic Kidney Disease.

机构信息

Instituto Nacional de Investigación Agropecuaria, Tacuarembó, Uruguay.

Laboratory of Veterinary Pathology, College of Veterinary Medicine, University of Brasília, Brazil.

出版信息

J Comp Pathol. 2020 Oct;180:100-104. doi: 10.1016/j.jcpa.2020.09.005. Epub 2020 Oct 10.

Abstract

Uraemic encephalopathy (UE) is rarely associated with acute kidney injury or chronic kidney disease in domestic animals, and we now report the first case in a cat. The animal presented with hypothermia, apathy, lethargy, depression, severe dehydration, uraemic breath, elevated serum urea nitrogen and creatine concentrations, and eventual seizures and coma prior to death. Gross necropsy findings included severe bilateral renal scarring, ulcerative stomatitis and glossitis, and uraemic gastropathy. Microscopic lesions of diffuse interstitial fibrosis, multifocal mineralization and lymphoplasmacytic interstitial nephritis were seen in the kidneys. There was symmetrical, bilateral spongy vacuolation of the white matter of the basal nuclei and cerebellum and Alzheimer type II astrocytes in the cerebral cortex and hippocampus. Glial fibrillary acid protein immunolabelling was absent or faint in astrocytes of the cerebral grey matter. UE should be included in the differential diagnosis in animals with chronic kidney disease and neurological signs.

摘要

尿毒症性脑病(UE)在宠物中很少与急性肾损伤或慢性肾脏病相关,我们现在报告首例猫的病例。该动物表现为体温过低、冷漠、昏睡、抑郁、严重脱水、尿毒症性呼吸、血清尿素氮和肌酸浓度升高,最终在死亡前出现癫痫发作和昏迷。大体剖检结果包括严重的双侧肾脏瘢痕形成、溃疡性口炎和舌炎以及尿毒症性胃炎。肾脏可见弥漫性间质纤维化、多灶性矿化和淋巴浆细胞性间质性肾炎的显微病变。基底核和小脑的白质以及大脑皮质和海马区呈对称的双侧海绵状空泡化。大脑灰质中的星形胶质细胞中的神经胶质纤维酸性蛋白免疫标记缺失或微弱。在患有慢性肾脏病和神经体征的动物中,应将 UE 纳入鉴别诊断。

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