Background: Thymomas are epithelial neoplasms of the thymus, although lymphocyte infiltration is common. Histological features are not sufficient to define its biological behaviour, which is dependent of clinical criteria of invasiveness and resectability. Myasthenia gravis may happen as a paraneoplastic syndrome in up to 47% of canine thymomas. Thisarticle aims at reporting a case of thymoma associated with myasthenia gravis in a dog, emphasizing the morphological, phenotypical and therapeutical aspects.Case: A 7-year-old, male Labrador, was presented with a history of acute dyspnea and exercise intolerance. The physical examination revealed a “red-brick” mucousa, tachycardia and cardiac and pulmonar hypofonese. Chest radiographs revealed an area of increased radiopacity in the cranial mediastinum without a plane of separation to the heart. The eccodopplercardiogram exam identified a poorly delimited mass adjacent to the base of the heart, measuring 9.5x6.8cm. Computed tomographydemonstrated it as an expansive neoformation (9.5x6.5x7.8cm). Mass was removed through intercostal thoracotomy and the removed tissue was submitted to histopathology with a diagnosis compatible with type AB thymoma (mixed). Immunohistochemistry was positive for AE1/AE3 citokeratin in 90% of epithelial cells, confirming tumour origin. Tumour infiltrating lymphocytes were positive for CD79a (70%) and CD3 (20%). The proliferation index (Ki-67 imunolabeling) was 60%. About 45 days after surgery the patient was presented with generalized muscle weakness and regurgitation, with confirmed megaesophagus on chest X-ray. Treatment with pyridostigmine was initiated because of suspected myasthenia gravis, and complete remission of the neurological signs occurred within a month. A chemotherapeutic protocol with carboplatin wasthen instituted. After four sessions, a new thoracic radiograph revealed tumour recurrence in the cranial mediastinum. Therefore, metronomic chemotherapy was started sequentially with oral chlorambucil and firocoxib. Patient remained well for nine months when regurgitation and muscle weakness re-initiated, even with pyridostigmine treatment. New chestX-ray demonstrated increased tumour mass and the owner decided for euthanasia, resulting in a survival time of 368 days.Discussion: The prognosis of the thymoma depends on the histological type, clinical staging and presence of paraneoplastic syndromes. Due to the heterogeneity of the cases, there are not enough studies available to compare the animals submitted to different therapeutic modalities. In humans, when possible, and in the absence of metastases, complete surgical resection is the standard treatment followed by chemotherapy and/or adjuvant radiotherapy. In dogs, surgical resection of thymomasshould be considered, despite the invasiveness detected in imaging studies. The presence of paraneoplastic syndromes, such as myasthenia gravis, are commonly associated with worse prognosis, however, as evidenced in this case, pyridostigmine was useful in maintaining the neuromuscular function and patient´s quality of life, along with surgery and adjuvant chemotherapy, which probably contributed to the increase of the expectation of life. Further studies are necessary to evaluate the efficacy of adjuvant chemotherapy in maximum tolerated and metronomic dosage, for thymic neoplasms in dogs.Keywords: thymus, neoplasia, paraneoplastic syndrome, carboplatin, cyclophosphamide.
A sepse tem se tornando um dos maiores desafios na medicina veterinária. A sepse é definida como uma disfunção orgânica decorrente de uma inadequada resposta imunológica frente a um agente infeccioso, ameaçando a vida do animal. O objetivo deste trabalho foi verificar a ocorrência das doenças de maior frequência que levaram os animais a sepse nos atendimentos realizados no Hospital Veterinário (HV) da Universidade Vila Velha (UVV), em Vila Velha/ Espírito Santo, Brasil, observando as alterações laboratoriais relacionadas à sepse e correlacionando com a expectativa de vida desses animais. Através de um estudo retrospectivo, houve o levantamento dos casos atendidos no período de agosto a dezembro de 2019. Os dados foram tabulados, e, analisados por software, utilizando nível de significância de 5%. As principais doenças que conduziram a sepse foram em ordem de frequência a erliquiose, piometra e gastroenterites; além disso, foi observado que os fatores influenciadores na sobrevida destes animais foram alteração nos valores de leucócitos totais (p=0,042) e a presença de azotemia (ureia p <0,001 e creatinina p=0,003). Demonstrou-se assim, a importância dos achados laboratoriais em conjunto com as alterações clínicas, permitindo agilidade na identificação de um quadro em curso de síndrome da resposta inflamatória (SRIS)/Sepse.
Sepsis has become one of the biggest challenges in veterinary medicine. Sepsis is defined as an organic dysfunction resulting from an inadequate immune response to an infectious agent, threatening the life of the animal. The aim of this study was to verify the occurrence of the most frequent diseases that led animals to sepsis in the consultations performed at the Veterinary Hospital (HV) of the Universidade Vila Velha (UVV), in Vila Velha/ Espírito Santo, Brazil, observing the laboratorial alterations related to sepsis and correlating them with the life expectancy of those animals. Through a retrospective study, there was a survey of the cases seen in the period from August to December 2019. The data were tabulated and analyzed by software using a 5% significance level. The main diseases that led to sepsis were in order of frequency erliquiosis, pyometra and gastroenteritis; furthermore, it was observed that the factors influencing the survival of these animals were alteration in the values of total leukocytes (p=0.042) and the presence of azotemia (urea p <0.001 and creatinine p=0.003). This demonstrated the importance of laboratory findings in conjunction with clinical changes, allowing agility in the identification of an ongoing systemic inflammatory response syndrome (SIRS).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.