Perspectives on Meningoencephalomyelitis of Unknown Origin

Coates, Joan R.; Jeffery, Nick D.

doi:10.1016/j.cvsm.2014.07.009

Cited by 95 publications

(186 citation statements)

References 144 publications

(299 reference statements)

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“…(Smith et al 2007, Gemmill 2008. Além disso, em muitas outras enfermidades os protocolos terapêuticos utilizam drogas imunossupressoras como no lúpus, anemia hemolítica autoimune, pênfigo, tumores, e até alguns casos de encefalites (Smith et al 2007, Coates & Jeffery 2014, Nafe et al 2014, Taylor et al 2014.…”

Section: Resultsunclassified

Estudo epidemiológico e avaliação de fatores de risco da infecção por Toxoplasma gondii e achados clinico-patológicos da infecção aguda em cães admitidos em um Hospital Escola Veterinário

et al. 2016

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RESUMO.-Esse trabalho teve como objetivo estudar a prevalência e respectivos fatores de risco para infecção do Toxoplasma gondii em cães provenientes de uma população We aimed to verify the prevalence and risk factors for Toxoplasma gondii infection in dogs addimitted at the hospital. We also assessed the occurrence rates and the clinical and pathological repercussion of the acute infection by T. gondii in these animals. Antibodies were detected in 7% (26/386) of a population of 386 dogs of both genders and different breeds and ages. Only variables, eating offal, rural origin and contact with cattle have significant values of p<0.05. Dogs from rural areas showed higher risk (OD=7.00) of infection than those of urban origin. In 6.5% (25/386) contact titles were detected (between 16 and 256); these titles do not necessarily mean acute infection, but only prior exposure. The recognition of prior infection by T. gondii is vital in those hospital patients. Depending on the cause of admission, although not being toxoplasmosis the responsible, the patient should receive prophylactic anti-parasite treatment or be monitored for further treatment in case of further acute occurrence of the disease by recrudescence of encysted bradyzoites. Only one dog (3:44%, 1/386) was admitted with high titer, what may be suggestive of acute infection (title of 4096). Although the dog with acute infection has shown neurological signs, caution is required not to extrapolate a false interpretation that toxoplasmosis is the main responsible for neurological signs, since numerous other cases included in this study had neurological signs without title of acute infection, even title of prior contact. Acute toxoplasmosis was not a significant clinic disease in this hospital; however differential diagnosis should be made in ill patients, especially those from rural areas, and definitive diagnosis must be reached for the correct therapeutic approach.

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Section: Resultsunclassified

Estudo epidemiológico e avaliação de fatores de risco da infecção por Toxoplasma gondii e achados clinico-patológicos da infecção aguda em cães admitidos em um Hospital Escola Veterinário

et al. 2016

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“…To be included in the diseased group for this study, dogs had to be greater than six months of age with a neurologic examination consistent with focal or multifocal neurological dysfunction. Additional inclusion criteria included negative PCR tests on cerebrospinal fluid, whole blood, or both for the infectious agents caused by members of the species or genera Toxoplasma gondii , Neospora caninum , Ehrlichia canis, Ehrlichia ewingii, Anaplasma, Neorickettsia, Bartonella, and Rickettsia ; the presence of multifocal T2‐weighted hyperintense lesions on MRI; and CSF pleocytosis with a nucleated cell count of greater than 5 cells/μL with greater than 50% mononuclear cells and a red blood cell count of less than 4,000 cells/μL . For cases in which a necropsy was performed, histopathologic confirmation of disease was accepted in the absence of infectious disease testing, MRI, and CSF.…”

Section: Methodsmentioning

confidence: 99%

“…Meningoencephalomyelitis of unknown origin (MUO) is a common neuroinflammatory disease of dogs suspected to be caused by an underlying immune‐mediated process. The classification of MUO includes several inflammatory diseases differentiated histopathologically, including necrotizing meningoencephalitis (NME), necrotizing leukoencephalitis (NLE), and granulomatous meningoencephalomyelitis (GME) . All of these diseases predominately affect small breed dogs, but disease occurs in other breeds .…”

mentioning

confidence: 99%

“…The classification of MUO includes several inflammatory diseases differentiated histopathologically, including necrotizing meningoencephalitis (NME), necrotizing leukoencephalitis (NLE), and granulomatous meningoencephalomyelitis (GME) . All of these diseases predominately affect small breed dogs, but disease occurs in other breeds . These diseases are histologically distinct, but without histological confirmation of disease, NME, NLE, and GME tend to be collectively referred to as MUO.…”

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confidence: 99%

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Metagenomic Investigation of Idiopathic Meningoencephalomyelitis in Dogs

Hoon-Hanks

McGrath

Tyler

et al. 2017

Veterinary Internal Medicne

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BackgroundMeningoencephalomyelitis of unknown origin (MUO) is a common and life‐threatening neuroinflammatory disease in dogs. Features of the disease are suggestive of an underlying immune‐mediated process, but the association of this disease with a pathogen is still unknown.Hypothesis/ObjectivesTo search for candidate etiologic agent associated with cases if MUO using next generation metagenomic sequencing.AnimalsTwenty‐two dogs diagnosed with either MUO (11/22; 10 CSF and 3 brain), or noninflammatory CNS diseases inconsistent with MUO (11/22; 11 CSF and 2 brain) that served as negative controls.MethodsA case control study was performed by identifying MUO and non‐MUO cases. Samples were blindly processed and then unblinded for comparative analyses. Inclusion criteria for MUO cases included consistent MRI lesions and inflammatory CSF with a negative PCR panel for infectious agents or histopathologic diagnosis. Dogs with glucocorticoid therapy within 2 weeks of sample collection were excluded. Fresh‐frozen cerebrospinal fluid (CSF; 21) and brain (5) samples were collected and RNA and DNA were extracted separately for shotgun metagenomic sequencing. Known positive samples were used as controls to validate our sequencing and analysis pipelines and to establish limits of detection. Sequencing results were analyzed at a nucleotide and protein level for broad comparison to known infectious organisms.ResultsNo candidate etiologic agents were identified in dogs with MUO.Conclusions and Clinical ImportanceThese results support but do not prove the hypothesis that MUO is not associated with infectious agents and might be an autoimmune disease.

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“…Cytarabine is commonly used by veterinary neurologists to treat meningoencephalomyelitis of unknown origin (MUO), a broad term used to describe noninfectious inflammatory diseases of the central nervous system (CNS). The term MUO includes three inflammatory diseases that are distinguished histopathologically as granulomatous meningoencephalomyelitis (GME), necrotizing leukoencephalitis, and necrotizing meningoencephalitis (Coates & Jeffery, ). In 2002, a protocol of 50 mg/m 2 SQ twice daily for two consecutive days every 3 weeks was extrapolated from previous research for the treatment of GME in dogs (Cuddon, Coates, & Murray, ; Ho, Carter, Loo, Abbott, & McBride, ; Scott‐Moncrieff et al, ).…”

Section: Introductionmentioning

confidence: 99%

The pharmacokinetics of cytarabine administered at three distinct subcutaneous dosing protocols in dogs with meningoencephalomyelitis of unknown origin

Jones

McGrath

Gustafson

2019

Vet Pharm & Therapeutics

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The objective of this study was to evaluate the pharmacokinetics of the standard cytarabine (Ara‐C) protocol (50 mg/m2 subcutaneously every 12 hr for 2 days) used for dogs with neuroinflammatory disease and compare it to two more practical protocols (a single 200 mg/m2 subcutaneous dose and two 100 mg/m2 subcutaneous doses every 12 hr). Four client‐owned dogs previously diagnosed with meningoencephalomyelitis of unknown origin were administered three distinct Ara‐C protocols with a 21‐day washout between each protocol. A complete blood count was performed seven days after each dosing protocol to assess for clinically relevant myelosuppression. No adverse events were observed. Plasma Ara‐C concentrations were measured using a validated liquid chromatography coupled to tandem mass spectrometry assay. The mean maximal concentrations in this study were 4,230, 9,293, and 16,675 ng/ml for a single dose of 50, 100, and 200 mg/m2, respectively. There was a linear relationship between dose and drug exposure. Drug exposure was similar regardless of the dosing protocol when the total dose was analyzed, with an area under the concentration versus time curve of 37,026, 38,465, and 32,510 ng × hr/ml for 50, 100, and 200 mg/m2, respectively.

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Perspectives on Meningoencephalomyelitis of Unknown Origin

Cited by 95 publications

References 144 publications

Estudo epidemiológico e avaliação de fatores de risco da infecção por Toxoplasma gondii e achados clinico-patológicos da infecção aguda em cães admitidos em um Hospital Escola Veterinário

Estudo epidemiológico e avaliação de fatores de risco da infecção por Toxoplasma gondii e achados clinico-patológicos da infecção aguda em cães admitidos em um Hospital Escola Veterinário

Metagenomic Investigation of Idiopathic Meningoencephalomyelitis in Dogs

The pharmacokinetics of cytarabine administered at three distinct subcutaneous dosing protocols in dogs with meningoencephalomyelitis of unknown origin

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