Immunosuppressive Doses Of Corticosteroids Research Articles

Steroid‐responsive meningitis‐arteritis secondary to septic arthritis due to Pasteurella multocida in a bull terrier puppy

AbstractA 3‐month‐old male, entire, English bull terrier was presented for investigation of a 24‐hour history of lethargy, pyrexia and neck pain. Inflammatory cerebrospinal and synovial fluid analyses with identification of Pasteurella multocida in the left stifle were supportive of a steroid‐responsive meningitis‐arteritis (SRMA) and immune‐mediated arthritis secondary to septic arthritis in the left stifle. The patient was successfully treated with amoxicillin/clavulanic acid and immunosuppressive doses of corticosteroids. Follow‐up sampling of cerebrospinal and synovial fluids revealed resolution of the septic arthritis and SRMA after 6 weeks of treatment. Medications were tapered and discontinued after 16 weeks of treatment without any signs of relapse. Follow‐up was 16 weeks. This is the first case report of SRMA with the identification of P. multocida septic arthritis as the suspected trigger.

Masticatory muscle myositis in Rottweiler – Case report

The clinical presentation of masticatory muscle myositis (MMM) in dogs reflects focal inflammatory myopathy of the muscles of mastication, while limb muscles are spared. Signs range from acute swelling of the temporalis and masseter muscles, restricted jaw movement, jaw pain, and exophthalmus, to muscle atrophy. The diagnosis is confirmed by a muscle biopsy. Early diagnosis and therapy with immunosuppressive doses of corticosteroids usually yields a good prognosis. This paper reports a case of MMM in a Rottweiler.

Magnetic resonance imaging of suspected idiopathic bilateral C2 hypertrophic ganglioneuritis in dogs.

To report the magnetic resonance imaging and clinical features of suspected idiopathic bilaterally symmetric hypertrophic ganglioneuritis affecting the C2 nerve roots. Retrospective analysis of case records of dogs with imaging findings suggestive of idiopathic bilateral C2 neuritis. Data analysed included signalment, history, clinical signs, clinical pathology results and magnetic resonance imaging findings. Nerve root enlargement and spinal cord changes were classified as clinically significant or incidental, and further graded as mild, moderate or severe based on the degree of spinal cord distortion/compression. Imaging features were also correlated with severity of neurological deficits. Twelve dogs, including nine Staffordshire bull terriers showed magnetic resonance imaging features suggestive of idiopathic hypertrophic neuritis of C2 nerve roots. Findings were considered incidental (4/12) or clinically significant (8/12) based on prior neurological examination. Changes were best visualised on transverse images at the level of the C1-2 intervertebral foramina. The degree of associated spinal cord compression subjectively correlated with the severity of the neurological deficits. All cases with clinically significant lesions that were treated with corticosteroids responded favourably. Bilaterally symmetric C2 neuritis likely represents idiopathic hypertrophic ganglioneuritis. Staffordshire bull terriers appear over represented. Immunosuppressive doses of corticosteroids should be considered for clinically significant lesions.

Poliartrite em cães - 27 casos (2007-2013)

O objetivo deste estudo foi identificar cães com poliartrite e obter informações a respeito da idade, sexo, raça, peso corporal, queixa principal, alterações no exame físico, do líquido sinovial e resposta à terapia instituída. Os cães sem raça definida e acima de seis anos de idade foram os mais acometidos e o principal sinal clínico observado foi dificuldade de locomoção (71,5%), seguido de dor articular (52,3%) e claudicação (33,3%). Febre e inapetência foram observadas em cinco (18,5%) e quatro cães (14,8%), respectivamente. As principais alterações hematológicas encontradas foram anemia não regenerativa (29,6%), leucocitose (26%) e trombocitopenia (18,5%). Os resultados da bioquímica sérica foram considerados normais em sete de 27 cães (26%) e as principais alterações foram hiperproteinemia (55,5%) e hipoalbuminemia (37%). A inflamação sinovial foi considerada acentuada em 17 cães (77,5%), sendo os neutrófilos predominantes em 52,4% dos casos (n=14). O tratamento foi realizado em 18 cães com doses imunossupressoras de corticosteroides, sendo efetivo em 89% dos casos

Co-infectie met Mycoplasma haemofelis en ‘Candidatus Mycoplasma haemominutum’ bij een kat met immuungemedieerde hemolytische anemie in België

Een jonge, mannelijke huiskat werd aangeboden voor zwakte en anorexia die reeds twee dagen aanhielden. Op klinisch onderzoek werden bleke slijmvliezen gezien, veroorzaakt door erge, regeneratieve, Coombs’ positieve, hemolytische anemie. Een bloeduitstrijkje toonde epicellulaire organismen aan, compatibel met Mycoplasma (vroeger bekend als Haemobartonella felis). Real-time polymerase chain reaction (RT-PCR) op EDTA-bloed identificeerde deze organismen als Mycoplasma haemofelis en ‘Candidatus Mycoplasma haemominutum’. Ondanks de blijvende aanwezigheid van de organismen in het bloed, reageerde de kat goed op antibioticatherapie met doxycycline, samen met een immunosuppressieve dosis corticosteroïden.

Cerebral haemorrhage in a pregnant Standardbred mare with Evan's syndrome

SummaryA 3‐year‐old pregnant Standardbred mare was treated at the University of Helsinki Equine Teaching Hospital for severe idiopathic immune‐mediated thrombocytopenia and haemolytic anaemia (Evan's syndrome). Despite initial improvement with supportive care and immunosuppressive doses of corticosteroids and azathioprine, the mare died from a fatal cerebral haemorrhage on Day 21 of treatment.

Iatrogenic Hyperadrenocorticism, Calcinosis Cutis, and Myocardial Infarction in a Dog Treated for IMT

An 8 yr old male English bulldog receiving treatment for immune-mediated thrombocytopenia was diagnosed with calcinosis cutis 90 days after initiation of corticosteroid therapy. Twenty-four days later, the patient presented in a comatose state after collapsing and was euthanized. Postmortem examination revealed coronary arteriosclerosis and myocardial infarction leading to congestive heart failure. Calcinosis cutis and myocardial necrosis were most likely complications associated with administration of corticosteroids in this dog. Important implications regarding the classification of calcinosis cutis and the use of immunosuppressive doses of corticosteroids are discussed.

Lack of Effect of Dexamethasone on Growth ofOrientia Tsutsugamushi Gilliamin Mouse L929 Cells

PurposePrevious studies and our own clinical experience suggest that concurrent corticosteroid treatment for severe rickettsial disease with multiorgan failure may improve the clinical course or reduce mortality. However, the use of corticosteroids as adjunctive treatment for rickettsial diseases is controversial. We attempted to determine the influences of corticosteroid on the growth of Orientia tsutsugamushi in vitro to justify and evaluate the clinical applicability of corticosteroid in rickettsial disease.Materials and MethodsL929 cells were infected with Orientia tsutsugamushi Gilliam. Dexamethasone was added to the cells at final concentrations of 101 and 107 pg/mL. Cultures were incubated at 35℃ and processed for flow cytometry on the 6th day after addition of dexamethasone.ResultsObservation on the 6th day after treatment with dexamethasone in infected cultures revealed that there was no difference in fluorescence intensity among the treatment wells. Treatment of the cells with dexamethasone at concentrations of 101 and 107 pg/mL showed no influence on the growth of Orientia tsutsugamushi.ConclusionOur results to show that isolated corticosteroid does not enhance the replication of Orientia tsutsugamushi in vitro. Concurrent use of anti-inflammatory or immunosuppressive doses of corticosteroids in conjunction with antibiotics may not have detrimental effects on the course of scrub typhus.

Immune‐mediated hemolytic anemia and severe thrombocytopenia in dogs: 12 cases (2001–2008)

To identify and characterize the syndrome of immune-mediated hemolytic anemia (IMHA) with concurrent severe thrombocytopenia (<or=15.0 x 10(9) platelets/L; [15.0 x 10(3) platelets/microL]), and to evaluate prognostic factors, clinicopathologic findings, complications, treatment, outcome, and survival of dogs with this hematologic disorder. Retrospective, observational study. Veterinary teaching hospital. Twelve client-owned dogs with IMHA and severe thrombocytopenia (<or=15.0 x 10(9) platelets/L; [15.0 x 10(3) platelets/microL]), without evidence of overt disseminated intravascular coagulation. The following data were recorded and analyzed from the electronic medical record: signalment, history, concurrent diseases, clinical signs at presentation, clinicopathologic data, diagnostic testing, radiographic findings, treatment modalities, length of hospitalization, complications, and clinical outcome. All dogs were treated with immunosuppressive doses of corticosteroids. Twelve dogs were identified with the diagnosis of IMHA and severe thrombocytopenia; of these, 9 (75%) survived, 3 (25%) were euthanized, and none died. Dogs that survived were significantly younger than nonsurvivors (P=0.03). There were no specific clinical signs or therapies associated with survival. Dogs in this study had a mortality rate similar to reported rates for dogs with either disease alone. Overall, younger dogs were more likely to survive. No association between different treatment modalities and overall survival was identified.

Central nervous system infection withStaphylococcus intermediussecondary to retrobulbar abscessation in a dog

In this report, we describe a case of retrobulbar abscessation in a dog that was initially diagnosed as masticatory myositis and treated with immunosuppressive doses of corticosteroids. Secondary bacterial infection of the central nervous system (CNS) occurred and was definitively diagnosed by the analysis and culture of the cerebrospinal fluid. This is the first time that retrobulbar infection has been definitively shown to result in secondary bacterial infection of the CNS in the dog and highlights the importance of ruling out infectious causes of retrobulbar disease before assuming and treating for an immune-mediated etiology.

Improved survival time in dogs with suspected GME treated with ciclosporin

IMMUNOSUPPRESSIVE doses of corticosteroids have been commonly recommended for the treatment of granulomatous meningoencephalomyelitis (GME), but the long-term prognosis is poor ([Munana and Luttgen 1998][1]). This short communication describes a study to investigate the effect of ciclosporin

Serial monitoring of clinical, haematological and immunological parameters in canine autoimmune haemolytic anaemia.

Clinical, haematological and immunological data are presented from 14 dogs with autoimmune haemolytic anaemia (AIHA) serially monitored for up to 945 days after initial presentation. At the time of diagnosis, all dogs had severe anaemia (mean packed cell volume [PCV] 17.6 +/- 7.1 per cent) with leucocytosis in seven cases and thrombocytopenia in four dogs. The Coombs' test was positive in all cases. Immunoglobulin G (IgG) autoantibody alone was identified in eight cases, a combination of IgG and IgM autoantibodies was recognised in three cases, and in two dogs only IgM autoantibody was recorded (complement fixing in one of these dogs). All dogs were treated with immunosuppressive doses of corticosteroids and some animals also received cyclophosphamide (four cases), azathioprine (two cases), blood transfusion (four cases) or underwent splenectomy (two cases). Two dogs died during the initial episode of AIHA. In 12 dogs, the anaemia was resolved by an average of 36.3 +/- 16.0 days after initial presentation, but autoantibody titre often persisted after clinical improvement and normalisation of PCV. Four dogs had a clinical relapse 67 to 170 days after initial presentation and one of these dogs subsequently died from thromboembolic disease. One dog developed lymphocytic thyroiditis and serum antinuclear antibody at day 691 after initial presentation, and two cases developed disease consistent with autoimmune thrombocytopenia (AITP) at 365 and 618 days post initial presentation. In one of these dogs, AITP was concurrent with multicentric lymphoma. No correlation was recorded between haematological and immunological parameters at presentation and subsequent response to therapy or long-term clinical behaviour.

Bilateral Cytomegalovirus Panuveitis after High-Dose Corticosteroid Therapy

A 30-year-old previously healthy woman who recieved immunosuppressive doses of corticosteroids developed an unusual culture-proved cytomegalovirus panuveitis bilaterally. The atypical clinical course was marked by bilateral exudative detachements with minimal evidence of retinitis. Any patient receiving blood transfusions and immunosuppressive doses of corticosteroids is potentially at risk for developing ocular cytomegalovirus infection, and the clinical presentation of the ocular infection may be atypical.