Bir köpekte immun ilişkili hemolitik anemi ve trombositopenin vineristine ile tedavisi

Bu olgu aşı uygulamasını takiben şekillendiği düşünülen immun ilişkili hemolitik anemi (IHA) ve trombositopeninin (ITP) vincristine ile sağaltımını irdelemek amacıyla değerlendirildi. Olguyu Uludağ Üniversitesi İç Hastalıkları kliniğine kusma ve karın altında morarma şikayeti ile getirilen 5 yaşlı, dişi Terrier ırkı köpek oluşturdu. Yapılan klinik muayenede mukozalarda solgunluk, ekstremitelerde ve abdomende peteşi ve ekimoz, laboratuar muayenelerinde de mikrositik bir anemi, yüksek MCHC değeri ve trombositopeni belirlenmiş olup kan frotisinin mikroskopik muayenesinde sferosit saptandı. Lam aglütinasyon testinde ise aglütinasyon pozitifti. Klinik ve laboratuar bulguları doğrultusunda immun-hemolitik anemi ve trombositopeni tanısı konulan hastada, tedavinin birinci günü prednisolon (2mg/kg i.v.), ranitidin (2,5mg/kg i.v.) ve sucralfate (200 mg P.O.) uygulandı. Tedavinin 3. gününde klinik bulgular ve laboratuar bulguları kötüye gittiği için hastaya kan nakli yapıldı ve vincristine (0.025 mg/kg, i.v., haftada bir kez 3 doz) tedavisine başlandı. Bu tedaviyi takiben 3. ve 9. günde klinik ve laboratuar bulgularında önemli bir düzelme belirlenmiş, 21. günde de olgunun tamamen normale döndüğü gözlenmiştir. Sonuç olarak aşı uygulamasını takiben şekillendiği düşünülen immun hemolitik anemi ve trombositopenilerde prednisolona yanıt alınamayan durumlarda vincristine ile tedavide başarılı sonuçlar alınabileceği kanısına varılmıştır.

Anahtar Kelimeler:

Canidae, trombositopeni, tedavi, hemolitik kansızlık, köpek

Treatment of immune- mediated hemolytic anemia and thrombocytopeni vinecistine in dog

This case was evaluated to discuss the effects of vincristine in the treatment of immune-mediated hemolytic anemia (IHA) and immune thrombocytopenia (ITP) which might be caused by vaccination. A 5 years old, female terrier was presented to the Clinics of Internal Medicine, University of Uludağ with the history of womiting and scattered discoloured areas on the abdomen. Pale mucous membranes, petechia and echymosis on the abdomen were observed clinically. Macrocytic anemia, high MCHC value, thrombocytepenia and spherocytes were determined on the laborotary examination. Also lam agglutination test was positive. Immune - mediated hemolytic anemia and immune thrombocytopenia was diagnosed based on the clinical and laboratory examination and prednisolone (2mg/kg, i.v.), ranitidine (2,5mg/kg, i.v.) and sucralfate (200mg, P.O.) were administered on the first day. Because of deterioration, blood transfusion and vincristine therapy (0.025 mg/kg, i.v., once weekly for 3 weeks) were administered for 3 days after initial treatment. On the 3rd and 9th days following the therapy, clinical signs and laboratory results were improved significantly. On the 21st day the dog was completely recovered. As a result, it was concluded that vaccination-induced IHA and ITP can be effectively treated with vincristine in the prednisolone resistant cases.

Keywords:

Canidae, thrombocytopenia, therapy, haemolytic anaemia, dogs,

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