病例报告:一只卡瓦利尔查理王小猎犬的遗传性大血小板减少症

Tzu-Yi Ma, Chih-Jung Kuo, Chih-Chung Chou, Pin-Chen Liu
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摘要

一只11个月大的完整雄性查理士王小猎犬(CKCS)因血小板减少症就诊于国立中兴大学教学医院(NCHU-VMTH),无相关临床症状,药物治疗后无明显改善。根据全血细胞分析,血小板明显减少(血小板计数为 1-[计算公式:见正文]L),平均血小板体积(MPV)为 20.3 至 25.7[计算公式:见正文]fl。犬巴贝斯虫、吉布森虫、犬埃立克虫和噬细胞嗜血杆菌的检测结果均为阴性。尽管使用了抗生素和免疫抑制剂,但该犬的病情并没有好转。从该犬的血小板形态和无症状来看,它被怀疑患有遗传性大血小板减少症。对[式中:见正文]1-tubulin 基因的基因组 DNA 测序分析发现了一个单点突变,具体为 c.745[式中:见正文]G>A。这项基因分析证实了[式:见正文]1-tubulin基因突变的存在,这也是台湾首例报告的CKCS基因突变病例。尽管诊断出了这种情况,但在绝育前,部分凝血活酶时间(PTT)和活性部分凝血活酶时间(aPTT)都在正常范围内。在诊断年轻患者血小板减少症的病因时,尤其是在没有相关临床症状时,必须优先考虑遗传性大血小板减少症,然后是继发于寄生虫感染的血小板减少症或免疫介导的血小板减少症(IMT),以尽量减少不必要的用药。
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CASE REPORT: INHERITED MACROTHROMBOCYTOPENIA IN A CAVALIER KING CHARLES SPANIEL
A 11-month-old intact male Cavalier King Charles Spaniel (CKCS) dog was presented at the Teaching Hospital of National Chung Hsin University (NCHU-VMTH) due to thrombocytopenia without relevant clinical signs and no significant improvement after medication treatment. As per the complete blood profile, there was significant thrombocytopenia (platelet count 1–[Formula: see text] L) with mean platelet volume (MPV) ranging from 20.3 to 25.7[Formula: see text]fl. Tests for Babesia canis, B. gibsoni, Ehrlichia canis and Anaplasma phagocytophilum yielded negative results. Despite treatment with antibiotics and immunosuppressive drugs, the dog’s condition did not improve. The dog’s platelet morphology and absence of symptoms raised the suspicion of inherited macrothrombocytopenia. Genomic DNA sequencing analysis of the [Formula: see text]1-tubulin gene revealed a single-point mutation, specifically c.745[Formula: see text]G>A. This genetic analysis confirmed the presence of a [Formula: see text]1-tubulin mutation, marking the first reported case of such a mutation in a CKCS in Taiwan. Despite the diagnosis of this condition, both partial thromboplastin time (PTT) and active partial thromboplastin time (aPTT) were within normal ranges before neutering. When diagnosing the causes of thrombocytopenia in young patients, especially when there are no related clinical signs, it is crucial to consider prioritizing inherited macrothrombocytopenia, then thrombocytopenia secondary to parasite infection, or immune-mediated thrombocytopenia (IMT) to minimize unnecessary medication.
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