Animal Health Trust, Suffolk, United Kingdom.
Davies Veterinary Specialists, Hertfordshire, United Kingdom.
J Vet Intern Med. 2022 Jan;36(1):78-85. doi: 10.1111/jvim.16315. Epub 2021 Nov 15.
The IV use of human immunoglobulin (hIVIG) in dogs with primary immune-mediated hemolytic anemia (IMHA) has been described previously, but herein we describe the use of high-dose IgM-enriched hIVIG (Pentaglobin).
HYPOTHESIS/OBJECTIVES: Dogs treated with high-dose Pentaglobin will experience shorter time to remission and hospital discharge and have decreased transfusion requirements compared to dogs receiving standard treatment alone.
Fourteen client-owned dogs diagnosed with primary IMHA at specialist referral hospitals in the United Kingdom.
All prospectively enrolled dogs received prednisolone, dexamethasone or both along with clopidogrel. Patients were randomized to receive Pentaglobin at 1 g/kg on up to 2 occasions, or to serve as controls. No additional immunosuppressive drugs were allowed within the first 7 days of treatment. Remission was defined as stable PCV for 24 hours followed by an increase in PCV.
Ten of 11 dogs from the treatment group and 2 of 3 dogs from the control group achieved remission and survived until hospital discharge. Survival and time to remission were not significantly different between groups. The volume of packed red blood cells transfused, normalized for body weight, was not significantly different between groups. Potential adverse reactions to Pentaglobin occurred in 2 dogs, but their clinical signs may have been related to the underlying disease.
Treatment with high-dose Pentaglobin was well tolerated by dogs with primary IMHA but no significant advantage was found in this small study. Additional studies examining larger groups and subpopulations of dogs with primary IMHA associated with a poorer prognosis are warranted.
先前已有将静脉注射用人类免疫球蛋白（hIVIG）用于治疗犬原发性免疫介导性溶血性贫血（IMHA）的报道，但在此我们描述了高剂量 IgM 浓缩 hIVIG（Pentaglobin）的应用。
假说/目的：与单独接受标准治疗的犬相比，接受高剂量 Pentaglobin 治疗的犬的缓解时间和出院时间更短，输血需求减少。
英国专科转诊医院确诊为原发性 IMHA 的 14 只患犬。
所有前瞻性入组的犬均接受泼尼松龙、地塞米松或两者联合氯吡格雷治疗。患者被随机分为接受 Pentaglobin 1 g/kg 治疗 2 次的治疗组或作为对照组。在治疗的前 7 天内不允许使用其他免疫抑制药物。缓解定义为 PCV 稳定 24 小时后增加。
在治疗组的 11 只犬中有 10 只，对照组的 3 只犬中有 2 只达到缓解并存活至出院。两组的生存时间和缓解时间无显著差异。经体重校正的输血量在两组之间无显著差异。Pentaglobin 的潜在不良反应发生在 2 只犬中，但它们的临床症状可能与基础疾病有关。
高剂量 Pentaglobin 治疗犬原发性 IMHA 耐受性良好，但在这项小型研究中未发现显著优势。需要进一步研究更大的犬群和预后较差的原发性 IMHA 亚群。
