Immune Mediated Disease 3
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
