狗的严重贫血和嗜中性粒细胞增多症,类似斯威特综合症

Leonardo Gaspareto dos Santos, Luana A. Camargo, Mariana Martins Flores, Alexandre Krause
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引用次数: 0

摘要

斯威特氏综合征是一种罕见的炎症性疾病,其特征是皮肤出现中性粒细胞浸润。我们描述了一例严重贫血和中性粒细胞增多,死后发现类似Sweet综合征,在一个五岁的女性拉布拉多寻回犬双侧鼻出血,呕血,缺氧,口腔黏膜苍白,发烧。实验室分析证实有严重的无反应性贫血、血小板减少症和白细胞增多症。生物化学显示低白蛋白血症,ALT和SAP活性升高。患者输血并接受强力霉素和强的松治疗一周,无好转。又输了两次血。骨髓分析显示轻度红细胞增生,粒细胞增生,髓红细胞比为6.01:1(参考文献:0.9:1 - 1.76:1),无发育不良,轻度巨核细胞增生,铁储量增加。巨噬细胞数量轻微增加伴红细胞增多,考虑免疫介导性贫血。免疫抑制治疗是为了减少红细胞破坏,但一周后没有观察到改善,并进行安乐死。坏死镜检查结果与系统性的斯威特综合征相似。骨髓组织病理学显示明显增加的颗粒生成和破坏血小板和红细胞。斯威特综合征常与血液恶性肿瘤或药物暴露有关。骨髓分析后排除白血病,因为未见细胞群增加,也未见发育不良的迹象。先前的治疗可能与斯威特综合征的发展有关,这可能是主要事件。虽然罕见,但在未确定感染源时,应考虑在皮肤病和白细胞增多症的鉴别诊断中。
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Severe anemia and neutrophilic leukocytosis resembling Sweet’s syndrome in a dog
Sweet’s syndrome is a rare inflammatory condition characterized by the presence of neutrophilic infiltrate of the skin. We describe a case of severe anemia and neutrophilia with post-mortem findings resembling Sweet's syndrome in a five-years-old female Labrador Retriever with bilateral epistaxis, hematemesis, hyporexia, pale oral mucosa, and fever. Laboratory analysis evidenced severe unresponsive anemia, thrombocytopenia, and leukocytosis. Biochemistry showed hypoalbuminemia and increased ALT and SAP activities. The patient was transfused and received doxycycline and prednisone for one week without improvement. Two further blood transfusions were administered. Bone marrow analysis showed a mild erythroid hypoplasia, granulocytic hyperplasia, myeloid to erythroid ratio of 6.01:1 (reference: 0.9:1 – 1.76:1) without dysplasia, mild megakaryocytic hyperplasia, and increased iron stores. Macrophages were slightly increased in number with erythrophagocytosis, and immune-mediated anemia was considered. Immunosuppressive treatment was prescribed to reduce red blood cell destruction, but no improvement after one week was observed, and euthanasia was performed. Necroscopic findings resembled those described for the systemic form of Sweet's Syndrome. Bone marrow histopathology showed remarkably increased granulopoiesis and destruction of platelets and erythrocytes. Sweet's syndrome is frequently associated with hematologic malignancy or drug exposure. Leukemia was excluded after bone marrow analysis because no increase in blast population was seen as well as no signs of dysplasia. Previous treatment could be related to the development of Sweet's syndrome, which might be the primary event. Although rare, this syndrome should be considered in the differential diagnosis of dermatosis and leukocytosis when infectious agents are not identified.
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来源期刊
Brazilian Journal of Veterinary Pathology
Brazilian Journal of Veterinary Pathology Veterinary-Veterinary (miscellaneous)
CiteScore
0.60
自引率
0.00%
发文量
24
期刊介绍: The Brazilian Journal of Veterinary Pathology is the official electronic periodical of the Brazilian Association of Veterinary Pathology. The purpose of the BJVP is to publish original full papers, short communications, case reports, letters, reviews (by invited experts) and abstracts of scientific meetings. The preferable subjects is natural and experimental pathology. All the articles are submitted to scientific reviewers.
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