Clinical, laboratory and therapeutic aspects of canine idiopathic hypereosinophilic syndrome: case report

Brizza Zorayd Luz Lopes Rocha,Mirlla Baracho Ferreira,Alessandra Moreira Da Silva,José Artur Brilhante Bezerra,Keylla Suellen Batalha Rocha Fernandes,Kayana Cunha Marques,Kilder Dantas Filgueira

doi:10.21708/avb.2018.12.3.7667

Brizza Zorayd Luz Lopes Rocha, Mirlla Baracho Ferreira + Show 5 more

Open Access

https://doi.org/10.21708/avb.2018.12.3.7667

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Abstract

The idiopathic hypereosinophilic syndrome (IHES) is a rare disease, characterized by variable eosinophilia and its massive infiltration into various organs. This study aimed to report clinical-laboratory findings and therapy in a canine with IHES. A one-year, 10-month-old male Rottweiler dog had a history of emesis, weight loss, hyporexia, and persistent eosinophilia on prior hematological exams. Vaccinations and worming were up to date. A complete blood count, serum biochemistry, bone marrow cytology, serology for leishmaniasis, chromatographic immunoassay for the detection of Dirofilaria immitis antigen, and abdominal ultrasound were requested. The tests for infectious diseases were negative. Blood biochemistry revealed no significant changes. An intense eosinophilia was observed in the hematology. A large number of cell precursors of the eosinophilic lineage were detected in the bone marrow cytology. Abdominal ultrasound showed thickening of intestinal loops. Considering the clinical and laboratory findings, the diagnosis of IHES was defined. Prednisolone treatment was instituted. The recurrence of peripheral eosinophilia occurred on the 35th day after therapy initiation. At that time, we opted to suspend the use of prednisolone and indicate the administration of deflazacort. With follow-up, therapeutic success with deflazacort was demonstrated, promoting the complete regression of clinical and ultrasound signs. The last glucocorticoid was maintained, but with a gradual dose reduction. The recognition of clinical and laboratory manifestations related to canine IHES is essential to establish an adequate diagnosis and therapy. Deflazacort emerges as a promising drug for controlling this disease.

Highlights

The idiopathic hypereosinophilic syndrome (IHES) is a condition described in humans, felines, ferrets, and more rarely in dogs (AROCH; PERL; MARKOVICS, 2001)
The diagnosis is made by associating the clinical signs with laboratory findings, especially with a persistent eosinophilia in the blood count, excluding the main causes of eosinophilia
There was the maintenance of peripheral eosinophilia, but with an absolute value lower than the previous blood count (Table 1) and with a reduction in the number of eosinophil precursors within the bone marrow (Figure 4A)

Summary

INTRODUCTION

The idiopathic hypereosinophilic syndrome (IHES) is a condition described in humans, felines, ferrets, and more rarely in dogs (AROCH; PERL; MARKOVICS, 2001). A reduction in colon thickness (0.8 cm) and persistence of structures in the epigastric area (but with regression of dimensions, which had an average value of 2.8 × 1.6 cm for both) was observed (Figures 2C and 2D). The ultrasound of the abdominal cavity showed a reduction in both the colon wall thickness (0.74 cm) and the dimensions of the rounded structures (average value of 1.78 × 1.19 cm for both) (Figures 3B and 3C). There was the maintenance of peripheral eosinophilia, but with an absolute value lower than the previous blood count (Table 1) and with a reduction in the number of eosinophil precursors within the bone marrow (Figure 4A). This dose was maintained, but with an expansion in the time of administration until the maintenance dose was obtained, which corresponded to 0.1 mg/kg every 72 hours

DISCUSSION

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CONCLUSION