Macrocytosis secondary to hydroxyurea therapy

Conrado, Francisco de Oliveira; Weeden, Amy L.; Speas, Abbie L.

doi:10.1111/vcp.12511

Cited by 3 publications

(4 citation statements)

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“…Although evaluation of dried blood smears or hematology instrument scatter plots can suggest agglutination, the panel does not consider these techniques adequate to confirm agglutination based on the possibility of overlapping rouleaux on blood smears and the potential for other causes of macrocytes on scattergram evaluation . Saline agglutination testing performed by mixing 4 drops of saline with 1 drop of blood has a reported specificity of 100% (95% CI, 95%‐100%) c for IMHA in dogs .…”

Section: Diagnosis Of Immune‐mediated Hemolytic Anemiamentioning

confidence: 99%

ACVIM consensus statement on the diagnosis of immune‐mediated hemolytic anemia in dogs and cats

Garden

Kidd

Mexas

et al. 2019

Veterinary Internal Medicne

126

196

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Immune‐mediated hemolytic anemia (IMHA) is an important cause of morbidity and mortality in dogs. IMHA also occurs in cats, although less commonly. IMHA is considered secondary when it can be attributed to an underlying disease, and as primary (idiopathic) if no cause is found. Eliminating diseases that cause IMHA may attenuate or stop immune‐mediated erythrocyte destruction, and adverse consequences of long‐term immunosuppressive treatment can be avoided. Infections, cancer, drugs, vaccines, and inflammatory processes may be underlying causes of IMHA. Evidence for these comorbidities has not been systematically evaluated, rendering evidence‐based decisions difficult. We identified and extracted data from studies published in the veterinary literature and developed a novel tool for evaluation of evidence quality, using it to assess study design, diagnostic criteria for IMHA, comorbidities, and causality. Succinct evidence summary statements were written, along with screening recommendations. Statements were refined by conducting 3 iterations of Delphi review with panel and task force members. Commentary was solicited from several professional bodies to maximize clinical applicability before the recommendations were submitted. The resulting document is intended to provide clinical guidelines for diagnosis of, and underlying disease screening for, IMHA in dogs and cats. These should be implemented with consideration of animal, owner, and geographical factors.

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Section: Diagnosis Of Immune‐mediated Hemolytic Anemiamentioning

confidence: 99%

ACVIM consensus statement on the diagnosis of immune‐mediated hemolytic anemia in dogs and cats

Garden

Kidd

Mexas

et al. 2019

Veterinary Internal Medicne

126

196

View full text Add to dashboard Cite

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“…1,2 Dosages are 30 mg/kg PO daily for 7-10 days, followed by the minimal effective dose, usually 15 mg/kg PO every 24-48 h. 4,14,16 Dosages of 50-60 mg/kg PO daily are also reported for dogs. 3,18,19 Reported adverse effects of hydroxyurea used at therapeutic doses include bone marrow suppression, signs of gastrointestinal disease, signs of dermatologic disease, and other less common adverse effects in humans (Table 1). 18 Bone marrow suppression occurs with chronic use and typically resolves after discontinuation or dose reduction.…”

Section: Discussionmentioning

confidence: 99%

“… 1 , 2 Dosages are 30 mg/kg PO daily for 7–10 days, followed by the minimal effective dose, usually 15 mg/kg PO every 24–48 h. 4 , 14 , 16 Dosages of 50–60 mg/kg PO daily are also reported for dogs. 3 , 18 , 19 …”

Section: Discussionmentioning

confidence: 99%

“…Humans Veterinary patients Hematologic Thrombocytopenia, anemia, leukopenia [20][21][22] Macrocytosis 20 Controversial leukemic transformation 20 Methemoglobinemia (1 report) 12 Thrombocytopenia, anemia, leukopenia 3,5 Macrocytosis 19 Gastrointestinal Nausea, diarrhea, gastritis 22,23 Anorexia, vomiting, diarrhea 18 Dermatologic Leg ulcers, pigmentation of skin or nails, alopecia 6,[20][21][22][23] Sloughing of nails, alopecia 3 Pulmonary Pulmonary edema, pulmonary fibrosis, pneumonitis 23,24 Not reported Neurological Headache, rare seizures 22 Not reported Other Liver enzyme elevation, 22 creatinine elevation, 22 arrest of spermatogenesis, 18 fever 23 Arrest of spermatogenesis 18 hydroxyurea had a time-dependent and dose-dependent increase in MetHb. [8][9][10] This effect is more pronounced on abnormal hemoglobin, suggesting variable susceptibility to oxidation.…”

Section: Type Of Adverse Effectsmentioning

confidence: 99%

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Clinical methemoglobinemia secondary to administration of hydroxyurea at therapeutic doses in a dog

Rigot,

Bateman,

Yiew

2024

Veterinary Internal Medicne

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Methemoglobinemia secondary to administration of hydroxyurea is only reported in veterinary medicine as a result of accidental ingestion of high doses, and once at therapeutic dose in human medicine. A 2.5‐year‐old female spayed mixed breed dog was presented for acute signs of neurologic disease and diagnosed with severe erythrocytosis without an identified underlying cause, leading to suspicion of polycythemia vera. The dog was managed with phlebotomies, supportive care, and administration of hydroxyurea. Within 2 h of administration of hydroxyurea (37 mg/kg) administration, respiratory distress with cyanosis, and methemoglobinemia developed. Signs resolved within 24 h but recurred after a second administration of lower dosage of hydroxyurea (17 mg/kg) 20 days later. The dog remained asymptomatic except for mild cyanosis but was humanely euthanized for lack of relevant improvement of signs of neurologic disease. This case report documents the repeated occurrence of methemoglobinemia in a dog after administration of hydroxyurea at therapeutic doses.

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