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
{"title":"Relapse Risk Factors for Immune-Mediated Hemolytic Anemia: A Retrospective Study of 163 Dogs.","authors":"Sidney Bannister, Deborah Keys, Ewan Wolff","doi":"10.5326/JAAHA-MS-7371","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":17185,"journal":{"name":"Journal of the American Animal Hospital Association","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Animal Hospital Association","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.5326/JAAHA-MS-7371","RegionNum":4,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}
引用次数: 0

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.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
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。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
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.
期刊最新文献
2022 AAHA Canine Vaccination Guidelines (2024 Update). 2024 AAHA Community Care Guidelines for Small Animal Practice. Long-term Outcome of a Chihuahua With Idiopathic Syndrome of Inappropriate Antidiuretic Hormone Secretion. Outcome, Complications, and Follow-Up in Dogs Treated with Pancarpal Arthrodesis Stabilized with Orthogonal Plates. Successful Management of Incompletely Resected Transitional Cell Carcinoma with Sorafenib Tosylate in a Dog.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1