Relapse Risk Factors for Immune-Mediated Hemolytic Anemia: A Retrospective Study of 163 Dogs.

IF 1.5 4区 农林科学 Q2 VETERINARY SCIENCES Journal of the American Animal Hospital Association Pub Date : 2024-09-01 DOI:10.5326/JAAHA-MS-7371
Sidney Bannister, Deborah Keys, Ewan Wolff
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Abstract

Immune-mediated hemolytic anemia (IMHA) is defined as an immune-mediated destruction of erythrocytes. Relapses are recognized, but risk factors are poorly defined. We hypothesized that a lower packed cell volume (PCV) on presentation, more transfusions during hospitalization, or a higher total bilirubin would be associated with an increased risk of relapse. IMHA was defined as a PCV less than 30% at diagnosis with two of the following identified: spherocytes, positive Coombs test, elevated total bilirubin, hemoglobinemia, or positive slide agglutination. This was a retrospective study evaluating 163 dogs between January 2005 and December 2019 from one specialty hospital. There were 13 relapses. The probability (95% confidence interval [CI]) of relapse by 3 and 12 mo was 0.05 (0.02-0.13) and 0.11 (0.06-0.22). The probability (95% CI) of relapse by 12 mo in patients who required two or more transfusions was 0.20 (0.09-0.42) compared with 0.07 (0.02-0.19) in patients who did not (P = .191). A lower PCV at diagnosis was not associated with an increased risk of relapse (hazard ratio [95% CI] 0.95 [0.86-1.04], P = .238). A higher total bilirubin was associated with a significantly increased risk of relapse (P = .003). With each increase of 1 mg/dL of total bilirubin, there was a 0.17 (95% CI 0.06-0.28) increase in the probability of relapse. These patients would likely need closer monitoring.

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免疫性溶血性贫血的复发风险因素:对 163 条狗的回顾性研究。
免疫介导的溶血性贫血(IMHA)被定义为免疫介导的红细胞破坏。人们已经认识到溶血性贫血会复发,但对其风险因素却知之甚少。我们假设,患者发病时包装细胞容积(PCV)较低、住院期间输血次数较多或总胆红素较高会增加复发风险。IMHA 的定义是:确诊时 PCV 低于 30%,同时发现以下两种情况:球形细胞、库姆斯氏试验阳性、总胆红素升高、血红蛋白血症或玻片凝集试验阳性。这是一项回顾性研究,对一家专科医院 2005 年 1 月至 2019 年 12 月间的 163 只犬进行了评估。共有 13 只犬复发。3个月和12个月后复发的概率(95%置信区间[CI])分别为0.05(0.02-0.13)和0.11(0.06-0.22)。需要输血两次或两次以上的患者 12 个月后复发的概率(95% 置信区间)为 0.20 (0.09-0.42),而不需要输血的患者复发的概率为 0.07 (0.02-0.19)(P = .191)。诊断时 PCV 较低与复发风险增加无关(危险比 [95% CI] 0.95 [0.86-1.04],P = .238)。总胆红素升高与复发风险显著增加有关(P = .003)。总胆红素每增加 1 毫克/分升,复发的可能性就增加 0.17 (95% CI 0.06-0.28)。这些患者可能需要更密切的监测。
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来源期刊
CiteScore
2.70
自引率
0.00%
发文量
57
审稿时长
18-36 weeks
期刊介绍: The purpose of the JAAHA is to publish relevant, original, timely scientific and technical information pertaining to the practice of small animal medicine and surgery.
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