Department of Veterinary Medicine and Surgery, University of Missouri, Ringgold Standard Institution - Small Animal Internal Medicine, Columbia, Missouri, USA.
University of Minnesota, Ringgold Standard Institution, Minneapolis, Minnesota, USA.
J Vet Intern Med. 2021 Jan;35(1):497-503. doi: 10.1111/jvim.15988. Epub 2020 Dec 4.
An approximately 1-year-old male intact Shih Tzu dog was referred to a tertiary facility with a history of progressive tachypnea, increased respiratory effort, and weight loss over a 3-month period that failed to improve with empirical antimicrobial treatment. Upon completion of a comprehensive respiratory evaluation, the dog was diagnosed with severe Pneumocystis pneumonia and secondary pulmonary hypertension. Clinical signs resolved and disease resolution was confirmed after completion of an 8-week course of trimethoprim-sulfonamide, 4-week tapering dose of prednisone to decrease an inflammatory response secondary to acute die-off of organisms, a 2-week course of clopidogrel to prevent clot formation, and a 2-week course of a phosphodiesterase-5 inhibitor to treat pulmonary hypertension. Immunodiagnostic testing and genetic sequencing were performed to evaluate for potential immunodeficiency as an underlying cause for the development Pneumocystis pneumonia, and identified an X-linked CD40 ligand deficiency.
一只大约 1 岁的雄性未绝育西施犬因进行性呼吸急促、呼吸努力增加和体重减轻而被转诊至三级医疗机构，经过 3 个月的经验性抗菌治疗后未见改善。在完成全面的呼吸道评估后，该犬被诊断患有严重的卡氏肺孢子虫肺炎和继发性肺动脉高压。在接受 8 周的甲氧苄啶-磺胺甲噁唑、4 周的泼尼松递减剂量以降低因急性菌体死亡引起的炎症反应、2 周的氯吡格雷以预防血栓形成和 2 周的磷酸二酯酶-5 抑制剂以治疗肺动脉高压治疗后，临床症状得到缓解，疾病得到确认。进行免疫诊断检测和基因测序以评估潜在的免疫缺陷是否为卡氏肺孢子虫肺炎发展的潜在原因，并确定存在 X 连锁 CD40 配体缺陷。
