Niedokrwistości ze szczególnym uwzględnieniem anemii immunohemolitycznych – cz. II

IMHA in cats

Immune-mediated hemolytic anemia characterized by the production of antibodies directed against erythrocytes appears to occur much less frequently in cats than in dogs. If the stimulus responsible for antibody production cannot be identified, the anemia is called primary or idiopathic immune-mediated hemolytic anemia (pIMHA). Several infectious agents, including the feline leukemia virus (FeLV), feline infectious peritonitis (FIP), and Mycoplasma hemofelis may induce secondary immune-mediated hemolytic anemia (sIMHA) in cats.

Moreover, drugs (eg, propylthiouracil) or tumors (eg, malignant lymphoma) can cause immune-mediated hemolysis. IMHA also has been described in cats suffering from systemic lupus erythematosus, or after blood transfusions from incompatible donors. Affected cats were typically young (median age 2 years). The anemia was generally severe (median hematocrit 12%) and often macrocytic. Absolute reticulocytosis was reported in less than half of the cases. In contrast to dogs, leukocytosis was present in only 10% of cats, and about 30% of cats exhibited lymphocytosis. Thrombocytopenia occurred in about 40% of cats with primary IMHA, and PT and/or APTT times were prolonged in 30% of the cats evaluated.

Hyperbilirubinemia occurred in nearly 70% of cats, with hyperglobulinemia reported in about half of cats with primary IMHA. A diagnosis of IMHA is made based on the presence of regenerative anemia and evidence of hemolysis (hyperbilirubinemia, hemoglobinemia, bilirubinuria, or hemoglobinuria). In addition, at least one of the following [...]

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