Immunohaemolytic anaemia (IHA) is a frequently diagnosed haematological disease of dogs. It is characterised by premature destruction of erythrocytes mediated by antibodies, with or without complement. Based on the type of immunological factors and erythrocyte damage IHA is classified into five groups (Table 1). The authors summarise the clinical findings, diagnostic possibilities and treatment protocols of IHA based on recent literature data. They emphasise the importance of including IHA in the differential diagnosis of haemolytic disease in Hungary, where babesiosis is common. Two typical cases of the disease are presented to demonstrate the clinical features of IHA. Major clinical signs of IHA consist of pale mucous membranes, icterus, fever, tachycardia and dyspnoea. Haematology shows regenerative anaemia and neutrophilic leukocytosis. Diagnosis is based on detecting spherocytes and autoagglutination in the blood smear (Figure 1), or performing an osmotic fragility test (Table 2 and Figure 2). A positive Coombs-test is considered supportive of the diagnosis. Urinalysis reveals bilirubinuria and sometimes haemoglobinuria. Glucocorticoids are the first choice of treatment, but cytotoxic agents like azathioprine and cyclophosphamide have also been suggested. Supportive care should include heparin when autoagglutination is present and blood transfusion if the severity of anaemia is life threatening. The seasonal pattern of the disease in Hungary was similar as experienced by authors in other countries. IHA similarly to babesiosis was more frequently encountered during spring and autumn (Figure 3). In one of the presented cases clinical signs compatible with cold agglutinin disease are described. In this dog necrosis of the ear margins (Figure 4) and toes (Figure 5) occurred a few weeks after initial presentation. In the authors experience aspiration cytology of the spleen and liver could support the diagnosis of IHA by detecting spherocytes, red blood cell phagocytosis, bilirubin and haemosiderin pigments in macrophages.
|Translated title of the contribution||Immunohaemolytic anaemia of dogs review and case report|
|Number of pages||7|
|Journal||Magyar Allatorvosok Lapja|
|Publication status||Published - Dec 1 1998|
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