Successful diagnosis and treatment of canine polymyositis: utilizing MRI and immunohistochemistry for accurate detection.

IF 2.3 2区 农林科学 Q1 VETERINARY SCIENCES
Jungwoo Han, KeunHwan Jang, Seung-Bum Cho, SuYeon Kim, Songju Oh, Ha-Jung Kim
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引用次数: 0

Abstract

Background: Inflammatory myopathy is generally categorized into generalized inflammatory myopathies (gIM), which affect muscles throughout the body, and focal inflammatory myopathies (fIM), which are localized to specific muscles or muscle groups. This report details a case of immune-mediated polymyositis in a dog, successfully diagnosed using MRI and IHC and managed with immunosuppressive therapy.

Case presentation: A 5-year-old castrated male Poodle was admitted to our hospital presenting with lethargy and exercise intolerance. Biochemical analysis revealed significantly elevated serum levels of aspartate aminotransferase (AST) and creatine kinase (CK). Physical examination showed muscle atrophy in the hind legs, but further orthopedic and neurological examinations identified no additional abnormalities. MRI demonstrated hyperintense and heterogeneous signal changes across the muscles, including contrast enhancement, suggesting inflammatory myopathy. This diagnosis was confirmed through histopathological examination, which revealed inflammatory lesions with fibrous tissue proliferation within the muscle tissue. To investigate the presence and type of inflammatory cells and vascular changes, aiding in the differential diagnosis of inflammatory myopathies, immunohistochemistry (IHC) was performed, revealing positive findings for CD8+, CD4+, and VEGF in the evaluated tissue, leading to a diagnosis of polymyositis.

Conclusions: The dog was diagnosed with immune-mediated polymyositis and treatment was initiated with prednisolone at 1 mg/kg twice daily and azathioprine at 2 mg/kg once daily. Following the administration of these immunosuppressive agents, CK levels returned to normal, and the dog's exercise intolerance and lethargy resolved. The thickness of the hind legs also increased progressively. The dog has maintained an improved condition under continued immunosuppressive therapy for four months. This case highlights the critical role of MRI and immunohistochemistry in diagnosing immune-mediated polymyositis, demonstrating their alternative capability in cases where conventional electromyography (EMG) is not feasible in this context.

犬多肌炎的成功诊断和治疗:利用MRI和免疫组织化学准确检测。
背景:炎症性肌病一般分为全身性炎症性肌病(gIM)和局灶性炎症性肌病(fIM),前者影响全身肌肉,后者局限于特定肌肉或肌群。本报告详细介绍了一例免疫介导的多肌炎在狗,成功诊断使用MRI和免疫组化和管理免疫抑制治疗。病例介绍:一只5岁的雄性被阉割的贵宾犬以嗜睡和运动不耐入院。生化分析显示血清谷草转氨酶(AST)和肌酸激酶(CK)水平显著升高。体格检查显示后腿肌肉萎缩,但进一步的骨科和神经学检查未发现其他异常。MRI显示高强度和不均匀的肌肉信号改变,包括对比增强,提示炎症性肌病。通过组织病理学检查证实了这一诊断,发现肌肉组织内有纤维组织增生的炎性病变。为了研究炎症细胞和血管变化的存在和类型,帮助鉴别诊断炎症性肌病,我们进行了免疫组化(IHC),在评估的组织中显示CD8+、CD4+和VEGF的阳性结果,从而诊断为多发性肌炎。结论:该犬诊断为免疫介导性多肌炎,治疗开始使用强的松龙剂量1 mg/kg,每日2次,硫唑嘌呤剂量2 mg/kg,每日1次。在给予这些免疫抑制剂后,CK水平恢复正常,狗的运动不耐受和嗜睡得到解决。后腿的厚度也逐渐增加。在持续四个月的免疫抑制治疗下,狗的状况有所改善。本病例强调了MRI和免疫组织化学在诊断免疫介导的多肌炎中的关键作用,证明了它们在常规肌电图(EMG)不可行的情况下的替代能力。
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来源期刊
BMC Veterinary Research
BMC Veterinary Research VETERINARY SCIENCES-
CiteScore
4.80
自引率
3.80%
发文量
420
审稿时长
3-6 weeks
期刊介绍: BMC Veterinary Research is an open access, peer-reviewed journal that considers articles on all aspects of veterinary science and medicine, including the epidemiology, diagnosis, prevention and treatment of medical conditions of domestic, companion, farm and wild animals, as well as the biomedical processes that underlie their health.
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