Černá Petra, Knies Marieke, Assink Marleen, Evans Samantha, Tasker Séverine, Gunn-Moore Danièlle A, Hartmann Katrin, Buchta Katharina, Taylor Samantha, Meunier Solène, Hofmann-Lehmann Regina, Jacque Nicole, Koonce Allison, Jacobs Casandra, Gillett Ashley, Lappin Michael R
Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CT Utrecht, The Netherlands.
Pathogens. 2025 Jul 4;14(7):660. doi: 10.3390/pathogens14070660.
Feline infectious peritonitis (FIP) is caused by mutated feline coronaviruses. Immune-mediated hemolytic anemia (IMHA) arises due to immune-mediated erythrocyte destruction and can be non-associative or associative with diseases such as FIP. Records of cats with FIP were reviewed to find those with associative IMHA based on exclusion of other causes of anemia and a positive saline agglutination test and/or Coombs test. The inclusion criteria were met for 45 cats (26 (58%) cats with effusive and 19 (42%) with non-effusive FIP). Median hematocrit was 18% (interquartile range [IQR] 13-20). Anemia was non-regenerative in 36 (80%) cats and regenerative in 5 (11%) cats; 4 (9%) cats had no reticulocyte count available. Concurrent thrombocytopenia was present in 18 (40%) cats. All 45 cats were treated with nucleoside analogs, and 44 (98%) cats with glucocorticoids; in 5 (11%) cats, glucocorticoids were added after starting antiviral treatment due to persistent anemia. Median follow-up was 72 days (IQR 14-246); at the time of last follow-up 33 (73%) cats had survived while 12 (27%) had died or were euthanized. Of the 33 surviving cats, 17 achieved remission of both FIP and IMHA. In three cats, FIP remission was achieved, but IMHA relapsed; in one of these, IMHA relapsed twice. FIP relapsed without IMHA in two cats, and both FIP and IMHA relapsed in one cat. In 9 cats the antiviral and glucocorticoid treatment is still ongoing at the time of the publication. Although FIP is likely an uncommon cause of associative IMHA, as more cats with FIP are treated with antiviral therapy, it is important to consider IMHA as a possible cause of anemia in cats with FIP.
猫传染性腹膜炎（FIP）由猫冠状病毒变异株引起。免疫介导的溶血性贫血（IMHA）是由于免疫介导的红细胞破坏所致，可与FIP等疾病无关或相关。回顾FIP猫的记录，以找出基于排除其他贫血原因以及盐水凝集试验和/或库姆斯试验呈阳性的相关IMHA猫。45只猫符合纳入标准（26只（58%）为渗出性FIP，19只（42%）为非渗出性FIP）。中位血细胞比容为18%（四分位间距[IQR]13 - 20）。36只（80%）猫的贫血为非再生性，5只（11%）猫为再生性；4只（9%）猫没有网织红细胞计数数据。18只（40%）猫同时存在血小板减少。所有45只猫均接受核苷类似物治疗，44只（98%）猫接受糖皮质激素治疗；5只（11%）猫因持续性贫血在开始抗病毒治疗后加用糖皮质激素。中位随访时间为72天（IQR 14 - 246）；在最后一次随访时，33只（73%）猫存活，12只（27%）猫死亡或被安乐死。在33只存活的猫中，17只FIP和IMHA均缓解。3只猫FIP缓解，但IMHA复发；其中1只猫IMHA复发两次。2只猫FIP复发但无IMHA复发，1只猫FIP和IMHA均复发。9只猫在发表时抗病毒和糖皮质激素治疗仍在进行。虽然FIP可能是相关IMHA的罕见原因，但随着越来越多的FIP猫接受抗病毒治疗，将IMHA视为FIP猫贫血的可能原因很重要。
