Duygu DALĞIN, YÜCEL MERAL, SİBEL UÇAK SEMİRGİN

Pernicious Anemia Due to Cobalamin Deficiency in Dogs with Helicobacter Gastritis

Kobalamin eksikliğine bağlı pernisiyöz anemi insan Helicobacter enfeksyonlarında baskın bir bulgu olmakla birlikte, bu anemi veteriner hekimlikte genellikle ekzokrin pankreatik yetmezlik ve intestinal hastalıklarda göz önüne alınmaktadır. Bu çalışmanın amacı, köpeklerde Helicobacter spp. enfeksiyonlarında kobalamin seviyelerinin araştırılmasıdır. Çalışmanın materyalini kliniklerimize kusma, iştahsızlık, bulantı ve anoreksi gibi muhtemel gastrointestinal sistem şikayetleriyle getirilen 81 köpekten üre nefes testi (14C-UBT) ile helikobakter enfeksiyonu tanısı konulan 58 (36 dişi ve 22 erkek) köpek oluşturmuştur. Bu köpeklere gastroskopi, tam kan sayımı, kan üre nitrojen (BUN), alanin aminotransferaz (ALT), aspartat aminotransferaz (AST), gama glutamil transferaz (GGT), alkalen fosfataz (ALP), lipaz, amilaz, total protein ve albumin seviyelerini kapsayan serum biyokimyasal tetkikler uygulanmıştır. Bu köpeklerden 38'inde (%65.51) mikrositik tipte anemi gözlenmiştir. Tüm hayvanlar metronidazol, amoksisilin, famotidin ve diyetsel düzenleme ile tedavi altına alınmış ve tedavinin tamamlanmasından sonra. 14C-UBT test, tam kan sayımı ve kobalamin seviyesi ölçümü tekrarlanmıştır. Anemili 38 köpekte kobalamin seviyesi ölçülmüş ve gastrik Helicobacter enfeksiyonlu ve mikrositik anemi gözlenen bu köpeklerde kobalamin seviyelerinin düşük olduğu görülmüştür. Anemili köpeklerde tedaviden sonra (B12 desteği verilmediği halde) kobalamin seviyesi ile ortalama hücresel hacim (MCV) ve hemoglobin (Hgb) değerlerinin normal referans aralıklara döndüğü gözlenmiştir. Bu durumda, klinik pratikte Helicobacter enfeksiyonlu köpeklerde kobalamin seviyesi belirlenmesi ve tedavi sonrası normal değerlere ulaşmadığı durumlarda takviye yapılması gerekebilir. Sonuç olarak, bu çalışmada Helicobacter gastritisli ve kan tablosunda mikrositik anemi gözlenen köpeklerde kobalamin eksikliği saptanması bu alandaki ilk çalışma olup, köpeklerde mikrositik anemi olan ve/veya olmayan Helicobacter gastritis olgularında kobalamin seviyesini ortaya koyan ileri çalışmalar faydalı olacaktır.

Helicobacter Gastritisli Köpeklerde Kobalamin Eksikliğine Bağlı Pernisiyöz Anemi

Pernicious anemia due to cobalamin deficiency is a predominant finding in human Helicobacter infections, but is generally considered in exocrine pancreatic insufficiency and intestinal disease in veterinary medicine. The aim of this study is to investigate the cobalamin levels in dogs infected with Helicobacter spp. Material of the study were selected from 81 dogs referred to our clinics with probable gastrointestinal system origined clinical complaints including vomiting, neusea, epigastric pain and anorexia, and consisted of 36 female and 22 male (n:58) dogs in which Helicobacter spp. gastritis was diagnosed with Urea Breath test (14C-UBT). To these dogs, gastroscopy, complete blood count, serum biochemistry including blood urea nitrogen (BUN), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), alkalen phosphatase (ALP), lipase, amylase, total protein and albumin levels were performed. In 38 dogs (65.51%) microcytic anemia was observed in complete blood count. All animals were treated with metronidazole, amoxycillin and famotidine and dietary management was scheduled. 14C-UBT test, complete blood count and cobalamine levels were reperformed after ceasion of the therapy. Cobalamin levels were analysed in 38 dogs with anemia. Low cobalamin levels were determined in dogs with gastric Helicobacter infection and anemia and after therapy-without any B12 supplementation- cobalamin levels and mean corpuscular volume (MCV) and Haemoglobin (Hgb) values elevated to normal reference limits were observed. This suggests that cobalamin level must be determined in dogs with Helicobacter infections and in deficiencies which are still present after therapy, essential supplementation would be clinically beneficial. In conclusion, this is the first study demonstrating that pernicious anemia must be a considered factor in Helicobacter gastritis with microcytic anemia in dogs and further investigation will be beneficial to demonstrate the cobalamin levels in dogs with or without microcytic anemia in Helicobacter gastritis.

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