Alterações laboratoriais em cães com anemia hemolítica imunomediada secundária (AHIM) responsiva e não responsiva
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Data
2020-07-17
Autores
Martinato, Fernanda [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
RESUMO. - A anemia hemolítica imunomediada (AHIM) é um dos tipos de anemia mais comumente diagnosticada em pequenos animais. A de origem secundária é mais prevalente em cães, a qual pode ser desencadeada por processos que culminam em resposta imunológica contra antígenos não- próprios opsonisados à membrana eritrocitária. Logo, a destruição dessas células ocorre devido uma reação de hipersensibilidade do tipo II, em que os anticorpos antieritrocitários atuam contra hemácias que possuem antígenos ligados à sua superfície. Algumas raças possuem predisposição para este tipo de anemia, além de estudos terem demonstrado predileção para sexo e idade. Para diagnóstico laboratorial, são levados em consideração a presença de esferócitos e autoaglutinação em solução salina, juntamente com o histórico clínico do animal, embora a negatividade desses testes não exclua a origem hemolítica da anemia. Uma das características deste tipo de anemia é a regeneração medular, marcada por presença de reticulócitos circulantes, apesar de uma grande parcela não apresentar regeneração no momento do diagnóstico. Sendo assim, o objetivo deste trabalho foi avaliar o comportamento hematológico de cães com AHIM secundária classificados como responsivos e não responsivos à anemia por meio da citometria de fluxo. Foi observado que 53,3% dos animais eram machos, enquanto 46,6% eram fêmeas, com a porcentagem de 6,25% e 21,4% abaixo de um ano de idade, respectivamente. A maior porcentagem (66,6%) dos cães foi de animais com idade igual ou maior a oito anos de idade. Quanto a responsividade medular, 73,3% dos animais tiveram anemia não regenerativa no momento do diagnóstico, sendo apenas 26,6% responsivos, os quais apresentaram menores resultados quanto aos valores de neutrófilos segmentados, bastonetes, eritroblastos e bilirrubina total, assim como menores índices de VCM e HCM, obtendo resultados superiores apenas nos valores de eritrócitos. Conclui-se que há possibilidade de diagnóstico deste tipo de anemia com testes laboratoriais aplicáveis na rotina e de baixo custo e que há diferença na avaliação laboratorial de animais com AHIM secundária responsiva e não responsiva, fazendo com que a investigação e determinação da não responsividade da anemia seja de extrema importância para melhor diagnóstico e tratamento do paciente.
Immune-mediated hemolytic anemia (IMHA) is one of the most commonly diagnosed types of anemia in small animals. A of secondary origin is more prevalent in dogs, which can be triggered by processes that culminate in immune response against opsonized antigens to the erythrocyte membrane. Therefore, the destruction of these cells occurs due to a type II hypersensitivity reaction, in which anti-erythrocyte antibodies act against erythrocytes that have antigens attached to their surface. Some breeds are predisposed to this type of anemia, in addition to studies showing a predilection for sex and age. For laboratory diagnosis, the presence of spherocytes and autoagglutination in saline together with the animal's clinical history are considered, although the negativity of these tests does not exclude the hemolytic origin of the anemia. One of the characteristics of this type of anemia is the medullary regeneration, marked by the presence of circulating reticulocytes, although a large portion does not present regeneration at the time of diagnosis. Thus, the objective of this study was to evaluate the hematological behavior of dogs with secondary AHIM classified as responsive and not responsive to anemia by means of flow cytometry. It was observed that 53.3% of the animals were male, while 46.6% were females, with a percentage of 6.25% and 21.4% under one year of age, respectively. The highest percentage (66.6%) of the dogs was from animals aged 8 years or more. As for spinal cord responsiveness, 73.3% of the animals had non-regenerative anemia at the time of diagnosis, and only 26.6% were responsive, which presented lower results regarding the values of segmented neutrophils, rods, erythroblasts and total bilirubin, as well as lower VCM and HCM indexes, obtaining superior results only in erythrocyte values. It is concluded that it is possible to diagnose this type of anemia with routine and low-cost laboratory tests and that there is a difference in the laboratory evaluation of animals with secondary non-responsive AHIM, causing the investigation and determination of non-responsiveness anemia is of utmost importance for better diagnosis and treatment of the patient.
Immune-mediated hemolytic anemia (IMHA) is one of the most commonly diagnosed types of anemia in small animals. A of secondary origin is more prevalent in dogs, which can be triggered by processes that culminate in immune response against opsonized antigens to the erythrocyte membrane. Therefore, the destruction of these cells occurs due to a type II hypersensitivity reaction, in which anti-erythrocyte antibodies act against erythrocytes that have antigens attached to their surface. Some breeds are predisposed to this type of anemia, in addition to studies showing a predilection for sex and age. For laboratory diagnosis, the presence of spherocytes and autoagglutination in saline together with the animal's clinical history are considered, although the negativity of these tests does not exclude the hemolytic origin of the anemia. One of the characteristics of this type of anemia is the medullary regeneration, marked by the presence of circulating reticulocytes, although a large portion does not present regeneration at the time of diagnosis. Thus, the objective of this study was to evaluate the hematological behavior of dogs with secondary AHIM classified as responsive and not responsive to anemia by means of flow cytometry. It was observed that 53.3% of the animals were male, while 46.6% were females, with a percentage of 6.25% and 21.4% under one year of age, respectively. The highest percentage (66.6%) of the dogs was from animals aged 8 years or more. As for spinal cord responsiveness, 73.3% of the animals had non-regenerative anemia at the time of diagnosis, and only 26.6% were responsive, which presented lower results regarding the values of segmented neutrophils, rods, erythroblasts and total bilirubin, as well as lower VCM and HCM indexes, obtaining superior results only in erythrocyte values. It is concluded that it is possible to diagnose this type of anemia with routine and low-cost laboratory tests and that there is a difference in the laboratory evaluation of animals with secondary non-responsive AHIM, causing the investigation and determination of non-responsiveness anemia is of utmost importance for better diagnosis and treatment of the patient.
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Palavras-chave
Citometria de fluxo, Hemólise, Hemolítica