Geisen Vera, Hartmann Katrin, Dörfelt René
LMU Small Animal Clinic, Ludwig Maximilian University of Munich, Munich, Germany.
Front Vet Sci. 2023 Jul 19;10:1183876. doi: 10.3389/fvets.2023.1183876. eCollection 2023.
Heinz Body (HB) anemia is a result of oxidative damage and is an uncommon condition in dogs relative to cats. In this retrospective case series, clinical features, laboratory values, concurrent diseases, and outcomes of 13 multimorbid dogs that developed HBs after receiving metamizole are reported.
Of the 13 dogs in this case series that developed HBs, 10 were older and multimorbid, but the only feature that all the dogs had in common was receiving metamizole. HBs were detected in 7 out of 13 dogs within a few days (3-10 days) after starting metamizole treatment. The metamizole dose was 38-159 mg/kg/day. The highest percentage of HBs detected was 28-95% (mean, 46%). There was no correlation between the percentage of HBs and the daily dose of metamizole. All but 1 dog had mild-to-severe anemia at the time of the highest HB appearance. The number of HBs did not correlate with the hematocrit at that time. In 8/12 dogs, no stress leukogram was present. Approximately half of the dogs with HBs also had evidence of gastrointestinal hemorrhage, which could have masked additional oxidative damage.
In multimorbid dogs that develop regenerative anemia after receiving metamizole, hemolysis due to HB development caused by oxidative damage should be considered as an important differential diagnosis.
海因茨小体（HB）贫血是氧化损伤的结果，在犬中相对于猫而言是一种不常见的病症。在这个回顾性病例系列中，报告了13只在接受安乃近后出现海因茨小体的多病犬的临床特征、实验室检查值、并发疾病及预后情况。
在这个病例系列中出现海因茨小体的13只犬中，10只为老龄且患有多种疾病，但所有犬唯一的共同特征是接受了安乃近治疗。在开始安乃近治疗后的几天内（3 - 10天），13只犬中有7只检测到海因茨小体。安乃近剂量为38 - 159毫克/千克/天。检测到的海因茨小体的最高比例为28% - 95%（平均为46%）。海因茨小体的比例与安乃近的日剂量之间没有相关性。除1只犬外，所有犬在海因茨小体出现最高值时均患有轻至重度贫血。此时海因茨小体的数量与血细胞比容不相关。在12只犬中有8只未出现应激白细胞象。大约一半出现海因茨小体的犬也有胃肠道出血的证据，这可能掩盖了额外的氧化损伤。
在接受安乃近后出现再生性贫血的多病犬中，应将氧化损伤导致海因茨小体形成引起的溶血视为重要的鉴别诊断。
