Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
J Vet Intern Med. 2023 Nov-Dec;37(6):2482-2487. doi: 10.1111/jvim.16882. Epub 2023 Sep 22.
We describe a case of presumptive acquired systemic lupus erythematosus secondary to phenobarbital administration in a dog, which resolved with withdrawal of the drug.
A 3.5 year-old poodle presented to a veterinary teaching hospital for Tier 1 idiopathic epilepsy and was treated with phenobarbital. The dog experienced fever, multiple cytopenias, and proteinuria in conjunction with a positive antinuclear antibody (ANA) titer.
Serial CBCs, urine protein : creatinine ratios, and sternal bone marrow aspirates were performed to evaluate improvement.
Phenobarbital was withdrawn and levetiracetam initiated. All abnormalities resolved with supportive care, without initiation of immunosuppressive drugs. All cytopenias and proteinuria resolved and ANA test results became negative within 3 months. The patient recovered and did well clinically.
Systemic lupus erythematosus is a disease of multiple autoimmune syndromes occurring concurrently or sequentially in conjunction with the presence of circulating ANA. It has been well described in dogs as an idiopathic condition, but in human medicine may occur secondary to drug reactions (drug-associated lupus) including as a reaction to phenobarbital. The findings in our case are consistent with the criteria for drug-induced lupus in humans and we suggest it as the first report of phenobarbital-induced lupus in a dog.
我们描述了一例犬因苯巴比妥治疗而继发获得性系统性红斑狼疮的病例，停药后疾病得到缓解。
一只 3.5 岁的贵宾犬因一级特发性癫痫到兽医教学医院就诊，接受苯巴比妥治疗。该犬出现发热、多种血细胞减少和蛋白尿，同时抗核抗体（ANA）滴度阳性。
进行了一系列的全血细胞计数（CBC）、尿蛋白/肌酐比值和胸骨骨髓抽吸检查，以评估病情改善情况。
停用苯巴比妥并开始使用左乙拉西坦。所有异常情况在支持性治疗下得到缓解，未使用免疫抑制剂。所有血细胞减少和蛋白尿均得到缓解，ANA 检测结果在 3 个月内转为阴性。该患者临床康复，情况良好。
系统性红斑狼疮是一种多种自身免疫综合征同时或先后发生的疾病，伴有循环 ANA 的存在。在犬中已被很好地描述为特发性疾病，但在人类医学中，它可能继发于药物反应（药物相关性狼疮），包括苯巴比妥反应。我们病例中的发现与人类药物诱导性狼疮的标准一致，我们建议这是首例犬苯巴比妥诱导性狼疮的报告。
