Niedokrwistości ze szczególnym uwzględnieniem anemii immunohemolitycznych – cz. II

Drugs Causing Immune-Mediated Anemia

Several drugs are reported to produce secondary IMHA in animals. These drugs include cephalosporins (dogs), levamisole (dogs), sulfonamides (dogs), pirimicarb (insecticide in dogs), and propylthiouracil (cats).

Diagnosing Immune Mediated Hemolytic Anemia

Some degree of immune-mediated cellular destruction occurs in many infectious, parasitic, neoplastic, inflammatory, and drug-induced diseases. For this reason the diagnosis of primary IMHA, also called autoimmune hemolytic anemia, is reached by ruling out other disorders known to produce secondary IMHA. Primary IMHA is common in dogs, less common in cats, and rare in other domestic animals. About two-thirds of the dogs with IMHA appear to have primary IMHA. In contrast, IMHA in noncanine species is usually secondary rather than primary.Primary IMHA may be associated with immune-mediated thrombocytopenia and it may also be part of systemic lupus erythematosus, a multisystemic autoimmune disease.

IMHA in dogs

Primary IMHA is typically seen in middle-aged dogs (average age 6 years), with intact and neutered female dogs, neutered male dogs, and cocker spaniel dogs being overrepresented. Autoagglutination is reported to occur in about 60% and Coomb’s test is positive in about 70% of dogs with primary IMHA. Spherocytosis is also present in about 75% of dogs with primary IMHA. Although the presence of spherocytosis strongly suggests that an immune-mediated process is present, other causes of spherocytosis – including exposure to venoms, zinc toxicity, transfusion of stored blood, and hereditary disorders – must be ruled out. Spherocytes are easily recognized only in dogs because other domestic animals have a significantly smaller area of central pallor in erythrocytes.

Neither the presence of spherocytes, a positive Coombs’ test, nor the increased osmotic red cell fragility indicate whether the etiology of the immune-mediated hemolysis is primary or secondary.

...

Ten materiał dostępny jest tylko dla użytkowników
którzy są subskrybentami naszego portalu.

Wybierz pakiet subskrypcji dla siebie
i ciesz się dostępem do bazy merytorycznej wiedzy!

Wybierz subskrypcję

Masz aktywną subskrypcję?

Zaloguj się

Nie masz jeszcze konta w serwisie? Dołącz do nas