犬免疫溶血性貧血之致病機轉與靜脈注射人類免疫球蛋白治療評估之研究(1/2)

Immune-mediated hemolytic anemia (IMHA) is a common cause of severe anemia
in dogs. IMHA can be diagnosed by detecting spherocytosis or autoagglutination in
blood smear, or by positive Coombs’ test. The aim of study was to establish the
Coombs’ assay system and to evaluate the therapeutic efficacy of intravenous
administration of human immunoglobulin (hIVIG) in dogs with IMHA. The Coombs’
test was performed on anticoagulated blood and used species-specific antiserum
prepared against immunoglobulins (IgG and IgM) and complement (anti-C3). Six
dogs with IMHA (were confirmed by positive Coombs’ test or autoagglutination)
were collected and treated with hIVIG intravenously (1g/kg) in 10- to 24-hour period.
Complete blood counts were repeated on days 1 through 7 and 14, 30, 60, 90, 120,
150, and 180 days after treatment. Four of six dogs are survival over 6 months and
still alive now. One of them was survival 4 months, and another only 3 weeks after
administration of hIVIG. Before therapy, the mean of hemoglobin concentration (Hb)
was 5.43 g/dl, hematocrit (Hct) was 17.70 %, and red cell count (RBC) was 2.16×
106/ìL. The levels of Hb, Hct and RBC were elevated to 9.03 g/dl, 31.45 %, 3.57 106/ìL 7 days after therapy. Hematological data of four surviving dogs recovered to
normal range 30 days after therapy. During the therapy, all of the dogs showed no
signs of immediate and delayed side effect, and the clinical signs were improved one
week after therapy. In conclusion, we have established Coombs’ assay system to
screen clinical suspected cases of IMHA; in addition, the results intravenous
administration of human immunoglobulin suggested, it is a good alternative agent in
treatment of IMHA.