Bloom J C, Blackmer S A, Bugelski P J, Sowinski J M, Saunders L Z
Vet Pathol. 1985 Sep;22(5):492-9. doi: 10.1177/030098588502200509.
In two seven-year studies with gold compounds in dogs of both sexes, thrombocytopenia was observed after 45 to 72 months of dosing in three of 14 and two of 14 dogs in high-dose groups that received 2.4 to 3.6 mg/kg of auranofin per day orally or 0.5 to 2.0 mg/kg of gold sodium thiomalate intramuscularly once every three days, respectively. An immune basis for the disorder was suggested by the apparent consumptive nature of the thrombocytopenia (increased bone marrow megakaryocytes and large peripheral blood platelets), the response to corticosteroid therapy and the demonstration of increased platelet-associated immunoglobulin. The latter was demonstrated with a solid phase radioimmunoassay and by electron microscopy using a staphylococcal protein A-colloidal gold conjugate. Platelet-associated immunoglobulin decreased as the platelet counts rose, and in one dog monitored over periods of steroid-induced remissions and subsequent relapses, the amount of platelet-associated immunoglobulin G correlated inversely with the platelet count (r = 0.82). These findings suggest that the long-term administration of gold compounds in dogs is associated with a dose-dependent incidence of thrombocytopenia, which is immune-mediated and similar to that associated with parenteral chrysotherapy in man. The application of tests for platelet-associated immunoglobulin to canine patients with immune thrombocytopenia should be useful in the diagnosis of the disorder in clinical practice.
在两项针对雌雄犬类使用金化合物的为期七年的研究中，高剂量组分别每日口服2.4至3.6毫克/千克的金诺芬或每三天肌肉注射0.5至2.0毫克/千克的硫代苹果酸金钠，14只犬中有3只和2只在给药45至72个月后出现血小板减少症。血小板减少症明显具有消耗性（骨髓巨核细胞增多和外周血大血小板增多）、对皮质类固醇治疗有反应以及血小板相关免疫球蛋白增加，提示该病症有免疫基础。后者通过固相放射免疫测定以及使用葡萄球菌蛋白A - 胶体金结合物的电子显微镜得以证实。随着血小板计数上升，血小板相关免疫球蛋白减少，在一只接受类固醇诱导缓解期及随后复发期监测的犬中，血小板相关免疫球蛋白G的量与血小板计数呈负相关（r = 0.82）。这些发现表明，犬长期使用金化合物与剂量依赖性血小板减少症的发生率相关，该血小板减少症是免疫介导的，与人类肠胃外金疗法相关的情况相似。对患有免疫性血小板减少症的犬类患者应用血小板相关免疫球蛋白检测，在临床实践中对该病症的诊断应是有用的。
