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一只犬的内脏利什曼病:临床、血液学及病理学观察

Visceral leishmaniasis in a dog: clinical, hematological and pathological observations.

作者信息

Tryphonas L, Zawidzka Z, Bernard M A, Janzen E A

出版信息

Can J Comp Med. 1977 Jan;41(1):1-12.

Abstract

Visceral leishmaniasis was diagnosed in a dog that had been living with his owners in Spain for two years. Clinical diagnosis was somewhat delayed as the disease is largely unknown to Canada and was manifested by a nonresponsive anemia which was not easily explained on peripheral blood evaluation alone, and concomitant interstitial nephritis. On post mortem examination splenomegaly was the main gross pathological finding. Light microscopic examination of bone marrow aspirates and subsequent electron microscopic examination of splenic and hepatic tissues revealed numerous Leishman-Donovan bodies in cells of the reticuloendothelial system. Parasitized reticuloendothelial cells were seen singly or forming granulomata. These latter did not contain giant cells and were confined mainly to the liver and spleen, being sparse and single in the first but extremely numerous and coalescing in the latter. Accumulation of intrafollicular hyaline material was seen in a small number of splenic follicles. Leishman-Donovan bodies on electron microscopic examination had a trilaminar periplast, a large round nucleus with heavy blocks of marginated chromatin and two nucleoli, a short flagellum and a kinetoplast. Lymph nodes and bone marrow had numerous parasitized macrophages but no granulomata. Leishman-Donovan bodies were not detected in the lungs and kidneys both of which exhibited a chronic intersitital reaction. The comparative hematological profile as well as the importance of bone marrow and electron microscopic examinations of the spleen and liver in diagnosis are discussed. The potential public health hazard of leishmaniasis to North America and particularly to Canada is considered.

摘要

一只与主人在西班牙生活了两年的狗被诊断出患有内脏利什曼病。由于加拿大对这种疾病知之甚少,临床诊断有所延迟,其表现为无反应性贫血,仅通过外周血评估难以解释,同时伴有间质性肾炎。尸检时,脾肿大是主要的大体病理发现。对骨髓穿刺物进行光镜检查,并随后对脾脏和肝脏组织进行电镜检查,发现网状内皮系统细胞中有大量利杜体。可见被寄生的网状内皮细胞单个存在或形成肉芽肿。后者不含巨细胞,主要局限于肝脏和脾脏,在前者中稀疏且单个存在,而在后者中则极其众多且融合成片。在少数脾滤泡中可见滤泡内透明物质的积聚。电镜检查显示,利杜体有三层周质、一个大的圆形核,核周有浓密的染色质块和两个核仁、一根短鞭毛和一个动基体。淋巴结和骨髓中有大量被寄生的巨噬细胞,但无肉芽肿。在肺和肾中未检测到利杜体,二者均表现为慢性间质反应。本文讨论了比较血液学特征以及骨髓和脾脏及肝脏电镜检查在诊断中的重要性。还考虑了利什曼病对北美尤其是加拿大潜在的公共卫生危害。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8d2/1277686/01e851857cf8/compmed00033-0009-a.jpg

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