Canine Immune-Mediated Polyarthritis

2012 ◽  
Vol 48 (2) ◽  
pp. 71-82 ◽  
Author(s):  
Kirstin C. Johnson ◽  
Andrew Mackin
Keyword(s):  
Drug Exposure ◽  
Joint Infection ◽  
Clinical Signs ◽  
Initial Response ◽  
Response To Therapy ◽  
Joint Fluid ◽  
Fluid Analysis ◽  
Immune Mediated ◽  
Remote Infection ◽  
Diagnostic Criterion

Canine immune-mediated polyarthritis (IMPA) is a diagnosis of exclusion based predominantly on clinical signs, characteristic joint fluid analysis, and elimination of potential joint infection. Ultimately, an appropriate and sustained response to immunosuppressive therapy may become the final diagnostic criterion used. Identifying associated disease processes, including breed-specific syndromes, remote infection, inflammation, drug exposure, vaccine exposure, or neoplasia, as well as initial response to therapy, is often an important contributor to prognosis. This review article is the second of a two part series and focuses on the diagnosis and treatment of immune-mediated polyarthritis. The first article in this series, published in the January/February 2012 issue, concentrated on the pathophysiology of IMPA.

Immune-Mediated Neutropenia in a Miniature Poodle

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Benjamin Brunson
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspirate ◽  
Clinical Signs ◽  
Response To Therapy ◽  
Tertiary Referral Center ◽  
Immune Mediated ◽  
Specialized Equipment ◽  
History Of ◽  
Light Sedation ◽  
The Right

ABSTRACT A 10 yr old spayed female toy poodle was presented to a tertiary referral center for a 10 day history of waxing and waning lethargy, vomiting, diarrhea, and anorexia. An immune-mediated neutropenia (IMN) was suspected to be the underlying cause of her clinical signs. A bone marrow aspirate was obtained from the chostochondral junction of the 11th and 12th ribs on the right side and provided a definitive diagnosis of IMN. A positive response to therapy and repeat blood work further confirmed the diagnosis. Obtaining bone marrow aspirates from the chostochondral junction is a safe, cheap, and reliable method of diagnosing IMN and can be performed in the private practice setting with light sedation and minimal need for specialized equipment.

Prosthetic Joint Infections

2016 ◽  
Author(s):  
David Mabey ◽  
Hasan E. Baydoun ◽  
Jamil D. Bayram
Keyword(s):  
Antimicrobial Prophylaxis ◽  
Joint Infection ◽  
Treatment Options ◽  
Joint Fluid ◽  
Care Providers ◽  
Joint Replacement Surgery ◽  
Fluid Analysis ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

Prosthetic joint infection (PJI), a complication of joint replacement surgery, presents with fever, joint pain, erythema, effusion, and joint loosening. Many advances have decreased the risk of infection, such as the use of perioperative antimicrobial prophylaxis and intraoperative laminar airflow. Joint fluid analysis should be pursued by the orthopedic surgeons; primary and acute care providers should consult the definitive care team and refer these patients for admission. Organisms causing prosthetic joint infections often grow in biofilms, which make them difficult to treat. Surgical treatment options include one or two-stage prosthesis exchange, debridement with retention of the prosthesis, resection arthroplasty, arthrodesis, or amputation. Antibiotic therapy should be guided by intraoperative cultures and selected in consultation with the infectious disease service.

Infection and arthritis

2020 ◽  
pp. 4457-4463
Author(s):  
Graham Raftery ◽  
Muddassir Shaikh
Keyword(s):  
Viral Infections ◽  
Joint Infection ◽  
Fluid Management ◽  
Clinical Signs ◽  
Joint Fluid ◽  
Causative Organism ◽  
Specialist Care ◽  
Prosthetic Joint ◽  
Clinical Illness ◽  
Gram Negative Organisms

Septic arthritis (or infective arthritis) is the most serious cause of one or more hot swollen joints. A causative organism can be identified in about 80% of cases, with Staphylococcus aureus the most common, followed by Streptococcus and gram-negative organisms. The key diagnostic investigation is microscopy and culture of aspirated joint fluid. Management is with drainage of bacteria, pus, and debris from the joint, along with antibiotics. Consensus is that these should be given intravenously for up to two weeks, or until clinical signs improve, followed by oral antibiotics for four weeks. Prosthetic joint infection is a particular challenge requiring specialist care. Arthralgia and/or arthritis are common occurrences with many viral infections, particularly parvovirus, hepatitis B and C, rubella, HIV, alpha (including chikungunya) and dengue viruses. Joint manifestations are usually sudden in onset, correlate with the onset of clinical illness, and generally self-limiting, but can persist following infection.

scholarly journals Erosive polyarthritis associated with Mycoplasma gateae in a cat

2007 ◽  
Vol 9 (3) ◽  
pp. 226-231 ◽  
Author(s):  
Florian Zeugswetter ◽  
Katharina M. Hittmair ◽  
Abigail G. de Arespacochaga ◽  
Sarina Shibly ◽  
Joachim Spergser
Keyword(s):  
Synovial Fluid ◽  
Clinical Signs ◽  
Strictly Anaerobic ◽  
Coombs Test ◽  
Anaerobic Culture ◽  
Rapid Improvement ◽  
Serological Tests ◽  
Radiographic Appearance ◽  
Fluid Analysis ◽  
Immune Mediated

Erosive polyarthritis was diagnosed in an 11-month-old neutered male Egyptian Mau-cross cat with concurrent glucocorticoid-responsive dermatitis. Clinical signs, synovial fluid analysis, serological tests and radiographic appearance could not differentiate between immune-mediated and infective arthritis. Mycoplasma gateae was isolated by strictly anaerobic culture of the synovial fluid. Treatment with Enrofloxacin led to a rapid improvement of the cat's condition. Two months later the cat was euthanased because of severe glomerulonephritis and direct Coombs' test positive anaemia, possibly caused by mycoplasma infection. M gateae could not be isolated at post-mortem examination.

Evaluation of clinical, radiographical and cytological findings compared to arthroscopic findings in shoulder joint lameness in the dog

2007 ◽  
Vol 02 (02) ◽  
pp. 136-141 ◽  
Author(s):  
L. Sjöström ◽  
S. Åkerblom
Keyword(s):  
Synovial Fluid ◽  
Shoulder Joint ◽  
Clinical Signs ◽  
Joint Fluid ◽  
Radiographic Examination ◽  
Pathological Changes ◽  
Fluid Analysis ◽  
Arthroscopic Findings ◽  
Set Protocol ◽  
Arthroscopic Examination

SummaryForty-two dogs with lameness emanating from the shoulder joint were studied by clinical examination, radiographic examination, joint fluid analysis, and arthroscopic examination, following a set protocol. Dogs with mild clinical signs, absent or mild radiographic signs of osteoarthrosis, and without or with very mild changes in the synovial fluid, may still have moderate to severe degenerative pathological changes in the shoulder joint.

scholarly journals Failure of Miltefosine Treatment in Two Dogs with NaturalLeishmania infantumInfection

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Daniela Proverbio ◽  
Eva Spada ◽  
Giada Bagnagatti De Giorgi ◽  
Roberta Perego
Keyword(s):  
Drug Resistance ◽  
Veterinary Medicine ◽  
Initial Treatment ◽  
Clinical Signs ◽  
Initial Response ◽  
Response To Therapy ◽  
The Other ◽  
Canine Leishmaniasis ◽  
Early Relapse ◽  
Meglumine Antimoniate

Two dogs, with naturally acquired canine leishmaniasis, were treated orally with miltefosine (2 mg/kg q 24 hr) and allopurinol (10 mg/kg q 12 hr) for 28 days. Both dogs showed good initial response to therapy, with reduction in clinical signs and improvement of clinicopathological changes. However, in both dogs, clinical and clinicopathological abnormalities recurred 150 days after initial treatment and a second course of miltefosine and allopurinol was administered. One dog failed to respond to the 2nd cycle of miltefosine treatment and the other dog responded initially but suffered an early relapse. Treatment with meglumine antimoniate (100 mg/kg q 24 hr for a minimum of 4 weeks) was then started in both dogs. Both dogs showed rapid clinical and clinicopathological improvement and to date they have not received further treatment for 420 and 270 days, respectively. In view of the low number of antileishmanial drugs available and the fact that some of these are used in human as well as veterinary medicine, it is of paramount importance that drug resistance is monitored and documented.

scholarly journals Myocarditis-associated necrotizing coronary vasculitis: incidence, cause, and outcome

2020 ◽  
Author(s):  
Andrea Frustaci ◽  
Maria Alfarano ◽  
Romina Verardo ◽  
Chiara Agrati ◽  
Rita Casetti ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Hypereosinophilic Syndrome ◽  
Left Ventricular ◽  
Response To Therapy ◽  
Left Ventricular Ejection ◽  
Toll Like Receptor ◽  
Toll Like Receptor 4 ◽  
Ventricular Ejection Fraction ◽  
Immune Mediated ◽  
Coronary Vasculitis

Abstract Aims  Necrotizing coronary vasculitis (NCV) is a rare entity usually associated to myocarditis which incidence, cause, and response to therapy is unreported. Methods and results  Among 1916 patients with biopsy-proven myocarditis, 30 had NCV. Endomyocardial samples were retrospectively investigated with immunohistochemistry for toll-like receptor 4 (TLR4) and real-time polymerase chain reaction (PCR) for viral genomes. Serum samples were processed for anti-heart autoantibodies (Abs), IL-1β, IL-6, IL-8, tumour necrosis factor (TNF)-α. Identification of an immunologic pathway (including virus-negativity, TLR4-, and Ab-positivity) was followed by immunosuppression. Myocarditis-NCV cohort was followed for 6 months with 2D-echo and/or cardiac magnetic resonance and compared with 60 Myocarditis patients and 30 controls. Increase in left ventricular ejection fraction ≥10% was classified as response to therapy. Control endomyocardial biopsy followed the end of treatment. Twenty-six Myocarditis-NCV patients presented with heart failure; four with electrical instability. Cause of Myocarditis-NCV included infectious agents (10%) and immune-mediated causes (chest trauma 3%; drug hypersensitivity 7%; hypereosinophilic syndrome 3%; primary autoimmune diseases 33%, idiopathic 44%). Abs were positive in immune-mediated Myocarditis-NCV and virus-negative Myocarditis; Myocarditis-NCV patients with Ab+ presented autoreactivity in vessel walls. Toll-like receptor 4 was overexpressed in immune-mediated forms and poorly detectable in viral. Interleukin-1β was significantly higher in Myocarditis-NCV than Myocarditis, the former presenting 24% in-hospital mortality compared with 1.5% of Myocarditis cohort. Immunosuppression induced improvement of cardiac function in 88% of Myocarditis-NCV and 86% of virus-negative Myocarditis patients. Conclusion  Necrotizing coronary vasculitis is histologically detectable in 1.5% of Myocarditis. Necrotizing coronary vasculitis includes viral and immune-mediated causes. Intra-hospital mortality is 24%. The immunologic pathway is associated with beneficial response to immunosuppression.

scholarly journals Comment on: The validation of a diagnostic rule for gout without joint fluid analysis: a prospective study

Rheumatology ◽  
2015 ◽  
Vol 54 (7) ◽  
pp. 1328-1329 ◽  
Author(s):  
Mariano Andrés ◽  
Eliseo Pascual ◽  
Paloma Vela
Keyword(s):  
Prospective Study ◽  
Joint Fluid ◽  
Fluid Analysis ◽  
A Prospective Study

scholarly journals Metastatic Breast Cancer with Extensive Osseous Metastasis Presenting with Symptomatic Immune Thrombocytopenic Purpura and Anemia: A Case Report and Review of the Literature

2015 ◽  
Vol 8 (2) ◽  
pp. 256-263 ◽  
Author(s):  
Jiaxin Niu ◽  
Teresa Goldin ◽  
Maurie Markman ◽  
Madappa N. Kundranda
Keyword(s):  
Breast Cancer ◽  
Platelet Count ◽  
Metastatic Breast Cancer ◽  
Immune Thrombocytopenic Purpura ◽  
English Literature ◽  
Metastatic Breast ◽  
Response To Therapy ◽  
Severe Thrombocytopenia ◽  
Thrombocytopenic Purpura ◽  
Immune Mediated

Background: Immune thrombocytopenic purpura (ITP) is a rare acquired bleeding disorder with an estimated incidence of 1 in 10,000 people in the general population. The association of ITP with breast cancer is an even rarer entity with very limited reports in the English literature. Case Presentation: We report a case of a 51-year-old female with no significant past medical history who presented with sudden onset of malaise, syncope, gingival bleed and epistaxis. She was found to have severe thrombocytopenia (platelet count 6,000/μl) and anemia (hemoglobin 7.2 g/dl). Her workup led to the diagnosis of metastatic ductal breast cancer with extensive bone metastasis. Bone marrow biopsy demonstrated myelophthisis which was initially thought to be consistent with her presentation of thrombocytopenia and anemia. Therefore, the patient was started on hormonal therapy for the treatment of her metastatic breast cancer. After 3 months of therapy, she did not improve and developed severe mucosal bleeding. Her clinical presentation was suspicious for ITP and immune-mediated anemia, and hence she was started on steroids and intravenous immunoglobulin. The patient had a dramatic response to therapy with normalization of her platelet count and hemoglobin within 2 weeks. Conclusion: To our knowledge, this is the first reported case of metastatic breast cancer presenting with symptomatic ITP and anemia, and both symptoms are postulated to be immune-mediated.

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