Polyarthritis due to systemic lupus erythematosus in a dog

Kruger, Rob; Franca, Raffaella; Filho, Saulo Tadeu Lemos Pinto; Schossler, João Eduardo Wallau

doi:10.1590/s0102-09352013000200014

Cited by 4 publications

(14 citation statements)

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“…A suspeita de LES foi levantada no presente caso devido às manifestações cutâneas observadas, caracterizadas por eritema e descamação em plano nasal, e úlceras em junção mucocutânea; mas também, pela trombocitopenia persistente acompanhada de esplenomegalia. Estas manifestações dermatológicas já foram bem descritas anteriormente por diversos autores [8,10,12]. A esplenomegalia ocorre com certa frequência (49,3%) em pacientes com LES [2,6,8,9].…”

Section: Discussionunclassified

“…Estas manifestações dermatológicas já foram bem descritas anteriormente por diversos autores [8,10,12]. A esplenomegalia ocorre com certa frequência (49,3%) em pacientes com LES [2,6,8,9]. Entretanto, o que levou o tutor, no presente caso, a procurar atendimento veterinário, foram as crises epilépticas e a incontinência urinária apresentadas pelo cão.…”

Section: Discussionunclassified

“…Entretanto, o que levou o tutor, no presente caso, a procurar atendimento veterinário, foram as crises epilépticas e a incontinência urinária apresentadas pelo cão. Alterações neurológicas são pouco frequentes no LES [8]. Crises epilépticas ocorrem em aproximadamente 15% dos pacientes humanos, sendo o tipo generalizado o mais frequente, e geralmente surgem no início da doença.…”

Section: Discussionunclassified

“…Os sinais clínicos variam de acordo com os órgãos acometidos, sendo as lesões cutâneas frequentemente encontradas. Despigmentação, eritema, descamação e úlceras em junções mucocutâneas são geralmente observadas na região nasal [6][7][8]10,13]. As manifestações sistêmicas incluem febre, letargia, anorexia, poliartrite e alterações neurológicas, que ocorrem em apenas 1,3 % dos casos [2,5,6].…”

Section: Introductionunclassified

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Systemic Lupus Erythematosus Associated with Neurological Manifestations in a Border Collie Bitch

Rosado

Picelli

Silva

et al. 2021

Acta Scientiae. Vet.

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Background: Systemic lupus erythematosus (SLE) is an immune-mediated and multisystemic disorder which etiology is believed to be multifactorial. Its clinical signs vary accordingly to affected organs, cutaneous lesions being the most frequently observed. There are few reports of SLE in dogs with neurological manifestations. Therefore, the aim of this report is to describe a case of SLE in a dog with indicative signs of nervous system involvement.Case: A 6-year-old Border Collie bitch was referred to the Veterinary Hospital (HVU) of the University of Uberaba (UNIUBE) with a history of with cluster seizures, inappetence and urinary incontinence. Erythema and flaking of nasal plan were noted on physical examination, and splenomegaly on abdominal palpation. Thrombocytopenia and slightly increased ALT were found on blood tests. Ehrlichiosis was suspected and doxycycline was prescribed together with phenobarbital for the control of seizures. In the follow-up visit, the dog was still presenting urinary incontinence, thrombocytopenia and splenomegaly. Also, an ulcer on the nasal mucocutaneous junction was observed. The patient went through a neurological examination which indicated thalamocortical lesion. Cerebrospinal fluid samples were obtained for cytology, culture and canine distemper test, and serology tests for leishmaniasis, toxoplasmosis and neosporosis were done. No alterations were found in these exams. The histopathology of the nasal lesion was proceeded and showed results consistent with lupus erythematosus. It was prescribed a 15-day course of prednisolone at immunosuppressive dose. The patient showed clinical improvement with this treatment. Azathioprine was started along with gradual removal of prednisolone. After twenty days of discontinuation of this drug, the dog presented epileptic seizures, urinary incontinence, thrombocytopenia, increased ALT and worsened nasal lesion. Prednisolone at immunosuppressive dose was reintroduced and the dose of azathioprine, increased. One week past this, the patient showed inappetence and an extensive hematoma in the thoracic region. Lab exams confirmed drug-induced acute pancreatitis. All medications were interrupted, the patient was hospitalized, and treatment for pancreatitis was initiated, but the dog passed away.Discussion: For involving multiple body systems and for presenting varied clinical signs, diagnosing SLE can be challenging in clinical routine. The dog from this report was a Border Collie; this breed is considered to be predisposed to this disease. The animal had a history of being exposed to solar radiation for a large part of the day, had dyspigmentation of nasal plan and had no application of sunscreen, predisposing the occurrence of SLE. Neurological signs are uncommon in SLE, but the seizures and the urinary incontinence were the main reasons for the dog’s guardian to look for medical assistance. The suspicion for SLE was raised due to cutaneous manifestations and persistent thrombocytopenia along with splenomegaly. Histopathological findings are essential for diagnosing SLE, as well as antinuclear antibody tests. Nonetheless, due to financial limitations, this last test was not performed. Azathioprine is an immunomodulating drug largely used along with glucocorticoids when treating SLE; however, this medication is prone to induce side effects as the ones presented by the dog from this report. Therefore, it is concluded that SLE should be considered as a differential diagnosis in patients showing cutaneous, hematological, systemic and neurological manifestations, considering the variety of signs caused by this disorder.Keywords: seizures, dog, immune-mediated encephalopathy. Lúpus eritematoso sistêmico associado a manifestações neurológicas em cadela da raça Border CollieDescritores: crises epilépticas, cão, encefalopatia imunomediada.

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Section: Discussionunclassified

Section: Introductionunclassified

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Systemic Lupus Erythematosus Associated with Neurological Manifestations in a Border Collie Bitch

Rosado

Picelli

Silva

et al. 2021

Acta Scientiae. Vet.

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“…For the treatment of SLE, prednisolone is preferred for immune suppression, while cyclophosphamide, cyclosporine, and levamisole are considered as alternatives [5,10]. Cyclosporine is primarily an immunosuppressive drug that selectively and reversibly inhibits only the T cell-mediated response [6].…”

Section: *Corresponding Authormentioning

confidence: 99%

Combination therapy of cyclosporine and prednisolone in a dog with systemic lupus erythematosus

Kim¹,

Kang²,

Park³

2016

Korean Journal of Veterinary Research

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: An 11-year-old, spayed female poodle presented with fever and shifting lameness. Physical examination revealed hyperthermia (40.6 o C), and proteinuria was detected upon urinalysis. Increased neutrophils (83%) and decreased viscosity were revealed upon synovial fluid analysis. Serum antinuclear antibody was positive at 1 : 80. Based on these findings, the dog was diagnosed with systemic lupus erythematosus. Immunosuppressive therapy was initiated with prednisolone and cyclosporine, and the condition was markedly improved after the treatments. This case report describes the clinical and laboratory findings, imaging characteristics and successful outcomes after prednisolone plus cyclosporine therapy in a canine systemic lupus erythematosus case.

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Estudo retrospectivo em 18 cães com lúpus eritematoso sistêmico (2008 – 2018)

Guimarães¹,

Conceição²,

Flaiban

et al. 2022

Pubvet

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O lúpus eritematoso sistêmico (LES) é uma doença imunomediada crônica multissistêmica com amplo espectro de apresentações clínicas devido ao envolvimento de diversos sistemas orgânicos, de modo que o LES pode resultar em uma variedade de sinais clínicos que não são patognomônicos da afecção e vários critérios clínicos são utilizados para o diagnóstico. É uma afecção incomum em cães e há poucos estudos sobre as características clínicas e laboratoriais do LES nesta espécie no Brasil. O objetivo do estudo foi avaliar as características clínicas e resultados de exames laboratoriais em cães com suspeita de LES atendidos entre 2008 e 2018 em um Hospital Veterinário Escola. O diagnóstico de LES foi realizado se houvesse positividade no teste de células LE e presença de pelo menos dois sinais maiores (lesões cutâneas, poliartrite, anemia hemolítica, glomerulonefrite, leucopenia e trombocitopenia) ou um sinal maior e dois menores (febre de origem desconhecida, alterações no sistema nervoso, ulceração oral, linfadenopatia, pericardite ou pleurite). Os dados coletados incluíram resenha e anamnese, sinais clínicos, achados de exame físico, hemograma completo, perfil de bioquímica sérica, pesquisa de doenças infecciosas e resposta ao tratamento. A maioria dos cães eram sem raça definida (SRD), de pequeno a médio porte com idade média de 4,86 anos. Fêmeas foram oito vezes mais acometidas do que machos. Os sinais clínicos mais comuns foram poliartrite, febre e lesões cutâneas. Em relação aos distúrbios hematológicos, a anemia foi a alteração mais observada, seguida da proteinúria. A terapia imunossupressora foi realizada em 16 cães, utilizando-se prednisona isolada ou em combinação com azatioprina, sendo que 15 cães melhoraram total ou parcialmente e 1 cão foi submetido à eutanásia. Embora o teste de células LE não seja considerado o exame padrão ouro para o diagnóstico atualmente, a associação desse teste com sinais laboratoriais e clínicos foi importante para o diagnóstico. O sucesso no tratamento de cães com LES depende do reconhecimento de todas as apresentações possíveis da doença e da escolha correta dos exames complementares.

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Polyarthritis due to systemic lupus erythematosus in a dog

Cited by 4 publications

References 8 publications

Systemic Lupus Erythematosus Associated with Neurological Manifestations in a Border Collie Bitch

Systemic Lupus Erythematosus Associated with Neurological Manifestations in a Border Collie Bitch

Combination therapy of cyclosporine and prednisolone in a dog with systemic lupus erythematosus

Estudo retrospectivo em 18 cães com lúpus eritematoso sistêmico (2008 – 2018)

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