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人用静脉注射免疫球蛋白治疗犬血液免疫介导性疾病。

Human intravenous immunoglobulin use for hematological immune-mediated disease in dogs.

机构信息

1Small Animal Internal Medicine, Queensland Veterinary Specialists, Brisbane, QLD, Australia.

2Torus Research, Brisbane, QLD, Australia.

出版信息

J Am Vet Med Assoc. 2023 Apr 18;261(7):1004-1010. doi: 10.2460/javma.23.01.0043. Print 2023 Jul 1.

Abstract

OBJECTIVE

To report on survival rates and risk factors in dogs with immune-mediated hemolytic anemia (IMHA) and immune-mediated thrombocytopenia (ITP) treated with human IV immunoglobulin (hIVIG; Privigen). We hypothesized that hIVIG could be used as a salvage treatment to improve survival and reduce the requirement for ongoing blood transfusion therapy in IMHA and ITP patients.

ANIMALS

52 client-owned dogs with IMHA or ITP were included, comprising 31 females (28 spayed and 3 entire) and 21 males (19 castrated and 2 entire). Miniature Schnauzers were the most common breed (5), with a further 24 different breeds identified.

PROCEDURES

A retrospective cohort study was conducted between January 2006 and January 2022 that assessed the survival rates, risk factors, and need for ongoing transfusion in dogs with IMHA and ITP treated with hIVIG compared with those not receiving hIVIG.

RESULTS

Of 36 dogs that did not receive hIVIG, 29 (80%) survived and 7 (24%) died, and of 16 dogs administered hIVIG, 11 (69%) survived and 5 (31%) died (P = .56). No effect of PCV at admission or age on the risk of death was detected (OR, 1.00; 95% CI, 0.94 to 1.08; P = .89; and OR, 1.10; 95% CI, 0.85 to 1.47; P = .47, respectively).

CLINICAL RELEVANCE

This was the largest study to date of dogs with hematological immune-mediated disease treated with hIVIG. There was no difference in survival rates for dogs that received hIVIG versus those treated with standard immunosuppression. The benefit of hIVIG as a salvage treatment appears limited.

摘要

目的

报告用人类静脉注射免疫球蛋白(hIVIG;Privigen)治疗免疫介导性溶血性贫血(IMHA)和免疫介导性血小板减少症(ITP)犬的存活率和相关风险因素。我们假设 hIVIG 可作为挽救性治疗,以提高生存率并减少 IMHA 和 ITP 患者对持续输血治疗的需求。

动物

纳入 52 只患有 IMHA 或 ITP 的患犬,包括 31 只雌性(28 只绝育和 3 只未绝育)和 21 只雄性(19 只绝育和 2 只未绝育)。迷你雪纳瑞是最常见的品种(5 只),另外还确定了 24 个不同的品种。

程序

2006 年 1 月至 2022 年 1 月期间进行了一项回顾性队列研究,评估了接受 hIVIG 治疗与未接受 hIVIG 治疗的 IMHA 和 ITP 犬的生存率、风险因素和持续输血需求。

结果

未接受 hIVIG 治疗的 36 只犬中,29 只(80%)存活,7 只(24%)死亡;接受 hIVIG 治疗的 16 只犬中,11 只(69%)存活,5 只(31%)死亡(P =.56)。未发现入院时的 PCV 或年龄对死亡风险有影响(OR,1.00;95%CI,0.94 至 1.08;P =.89;和 OR,1.10;95%CI,0.85 至 1.47;P =.47)。

临床相关性

这是迄今为止关于用 hIVIG 治疗血液系统免疫介导性疾病犬的最大研究。接受 hIVIG 治疗的犬与接受标准免疫抑制治疗的犬的生存率无差异。hIVIG 作为挽救性治疗的益处似乎有限。

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