Immune Mediated Disease 3

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Cytologic synovial fluid analysis

Cell count, <1500 normal, 1500-3000 grey area, high inflammatory, normal to mild increase degenerative, cytology

What are clinical signs of idiopathic immune mediated polyarthritis?

Lameness, fever, abnormal gait, limited ambulation, depression, anorexia

Idiopathic immune mediated polyarthritis

Antibodies directed against synovial membrane, antigen antibody complex deposition

Idiopathic immune mediated thrombocytopenia?

Antibody mediated destruction of platelets, antibodies directed against platelet glycoproteins

Rheumatoid arthritis

Antibodies directed against host immunoglobulins, severe immune complex deposition (type 2 HS), severe synovitis with secondary bone destruction, rare

Erosive

Associated with more severe and long lasting orthopedic isssues

What are causes of severe thrombocytopenia?

Bone marrow, DIC, vasculitis, immune mediated

What breeds are at risk for ITP in dogs?

Cocker spaniels, female, middle aged (6y)

Gross synovial fluid analysis

Color, turbidity, viscosity, protein

How do you determine regeneration?

Confirm with bone marrow, suggested by platelet size (MPV)

What are clinical signs of polyarthritis?

Fever (103.5), polyarthropathy (swollen joints left and right carpi, right stifle, left and right tarsi), painful on joint manipulation, minimal ambulation

What causes DIC?

IMHA, RMSF, hepatic failure, severe pancreatitis, sepsis

What causes nonerosive polyarthritis in dogs?

Idiopathic, systemic lupus erythematosus (SLE), polymyositis/polyarthritis, paraneoplastic

What causes nonerosive polyarthritis in cats?

Idiopathic, systemic lupus erythematosus, paraneoplastic, infectious calicivirus

What breeds are at risk for idiopathic immune mediated polyarthritis in dogs?

Middle aged, large breeds

Systemic lupus erythematosus

Multisystemic immune mediated disease, antibodies directed against nucleated cells, type 2 and 3 hypersensitivity reaction

What causes bone marrow destruction?

Myelophthisis (neoplastic effacement), myelofibrosis (IM), toxin (estrogen), infection (ehrlichia)

What causes secondary ITP?

Neoplasia (LSA, leukemia), ehrlichia (autoantibodies), anaplasma (autoantibodies), anaplasma platys targets platelets, drugs (TMS, methimazole), vaccines (similar to IMHA)

What is clin path of idiopathic immune mediated polyarthritis?

None, inflammatory leukogram, inflammatory synovial fluid (neutrophilic inflammation)

What are clinical signs of systemic lupus erythematosus?

Nonerosive, fever, glomerulonephritis, skin leasions

What causes proliferative polyarthritis in cats?

Periosteal proliferative polyarthritis

What are clinical signs of ITP?

Petechia/ecchymoses, hematuria, hemoptysis, hematemesis, hematochezia/melena, hyphema, signs of anemia, CNS signs

What is most common clinical sign of systemic lupus erythematosus in dogs?

Polyarthritis

What are causes of immune mediated thrombocytopenia?

Primary/idiopathic, secondary (neoplasia, infection, drugs/toxin, vax)

What causes erosive polyarthritis in cats?

Rheumatoid arthritis

What causes erosive polyarthritis in dogs?

Rheumatoid arthritis, greyhound polyarthritis

DIC

Severe consumption increased demand, secondary IMTP

What is clin path of ITP?

Severe thrombocytopenia, enlarged platelets, leukocytosis with left shift, anemia, hematuria


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