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Description of the Use of Plasma Exchange in Dogs With Cutaneous and Renal Glomerular Vasculopathy

Cutaneous and renal glomerular vasculopathy (CRGV) is a rare disease affecting dogs, with a recent apparent increase in prevalence since 2012 in the UK. This disease is characterized by a vasculopathy affecting small vessels of the kidney and skin, leading to thrombotic microangiopathy. The underlyi...

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Autores principales: Skulberg, Ragnhild, Cortellini, Stefano, Chan, Daniel L., Stanzani, Giacomo, Jepson, Rosanne E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060235/
https://www.ncbi.nlm.nih.gov/pubmed/30073173
http://dx.doi.org/10.3389/fvets.2018.00161
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author Skulberg, Ragnhild
Cortellini, Stefano
Chan, Daniel L.
Stanzani, Giacomo
Jepson, Rosanne E.
author_facet Skulberg, Ragnhild
Cortellini, Stefano
Chan, Daniel L.
Stanzani, Giacomo
Jepson, Rosanne E.
author_sort Skulberg, Ragnhild
collection PubMed
description Cutaneous and renal glomerular vasculopathy (CRGV) is a rare disease affecting dogs, with a recent apparent increase in prevalence since 2012 in the UK. This disease is characterized by a vasculopathy affecting small vessels of the kidney and skin, leading to thrombotic microangiopathy. The underlying etiology remains unknown although clinicopathological and histological findings resemble features of certain forms of thrombotic microangiopathy in people, for which plasma exchange (PEX) is considered an important component of therapy. The objective of the present study is to describe the use of PEX as adjunctive treatment in dogs diagnosed with CRGV. A retrospective review of dogs diagnosed with CRGV between 2014 and 2016 treated with PEX was performed. Clinical records were reviewed and data relating to signalment, diagnostic tests and management strategies were summarized. Information and complications relating to PEX were recorded. Six dogs were diagnosed with CRGV (n = 2 ante-mortem, n = 4 post-mortem) and underwent PEX as part of their therapy. All dogs had cutaneous lesions and were azotemic with oliguria or anuria. All dogs underwent at least one PEX cycle; one dog had a single cycle PEX, three dogs two cycles PEX, and two dogs had one cycle PEX and one cycle of prolonged intermittent renal replacement treatment. Complications seen during PEX therapy included hypothermia (n = 4), tachycardia (n = 2), hypotension (n = 2), and hypocalcemia (n = 6). Two dogs survived to discharge, the remaining four dogs were euthanized. The positive outcome in two dogs treated with PEX despite the reported high mortality rate once acute kidney injury with oliguria/anuria occurs does not confirm success of this treatment. However, survival in two dogs that were initially oligoanuric highlights that further consideration and evaluation of PEX for this patient group is warranted for this specific disease. Additional studies are urgently needed to identify the underlying etiology of CRGV before more targeted therapies can be developed. Based on our findings, further evaluation of the role of PEX in this specific disease are warranted.
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spelling pubmed-60602352018-08-02 Description of the Use of Plasma Exchange in Dogs With Cutaneous and Renal Glomerular Vasculopathy Skulberg, Ragnhild Cortellini, Stefano Chan, Daniel L. Stanzani, Giacomo Jepson, Rosanne E. Front Vet Sci Veterinary Science Cutaneous and renal glomerular vasculopathy (CRGV) is a rare disease affecting dogs, with a recent apparent increase in prevalence since 2012 in the UK. This disease is characterized by a vasculopathy affecting small vessels of the kidney and skin, leading to thrombotic microangiopathy. The underlying etiology remains unknown although clinicopathological and histological findings resemble features of certain forms of thrombotic microangiopathy in people, for which plasma exchange (PEX) is considered an important component of therapy. The objective of the present study is to describe the use of PEX as adjunctive treatment in dogs diagnosed with CRGV. A retrospective review of dogs diagnosed with CRGV between 2014 and 2016 treated with PEX was performed. Clinical records were reviewed and data relating to signalment, diagnostic tests and management strategies were summarized. Information and complications relating to PEX were recorded. Six dogs were diagnosed with CRGV (n = 2 ante-mortem, n = 4 post-mortem) and underwent PEX as part of their therapy. All dogs had cutaneous lesions and were azotemic with oliguria or anuria. All dogs underwent at least one PEX cycle; one dog had a single cycle PEX, three dogs two cycles PEX, and two dogs had one cycle PEX and one cycle of prolonged intermittent renal replacement treatment. Complications seen during PEX therapy included hypothermia (n = 4), tachycardia (n = 2), hypotension (n = 2), and hypocalcemia (n = 6). Two dogs survived to discharge, the remaining four dogs were euthanized. The positive outcome in two dogs treated with PEX despite the reported high mortality rate once acute kidney injury with oliguria/anuria occurs does not confirm success of this treatment. However, survival in two dogs that were initially oligoanuric highlights that further consideration and evaluation of PEX for this patient group is warranted for this specific disease. Additional studies are urgently needed to identify the underlying etiology of CRGV before more targeted therapies can be developed. Based on our findings, further evaluation of the role of PEX in this specific disease are warranted. Frontiers Media S.A. 2018-07-19 /pmc/articles/PMC6060235/ /pubmed/30073173 http://dx.doi.org/10.3389/fvets.2018.00161 Text en Copyright © 2018 Skulberg, Cortellini, Chan, Stanzani and Jepson. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Veterinary Science
Skulberg, Ragnhild
Cortellini, Stefano
Chan, Daniel L.
Stanzani, Giacomo
Jepson, Rosanne E.
Description of the Use of Plasma Exchange in Dogs With Cutaneous and Renal Glomerular Vasculopathy
title Description of the Use of Plasma Exchange in Dogs With Cutaneous and Renal Glomerular Vasculopathy
title_full Description of the Use of Plasma Exchange in Dogs With Cutaneous and Renal Glomerular Vasculopathy
title_fullStr Description of the Use of Plasma Exchange in Dogs With Cutaneous and Renal Glomerular Vasculopathy
title_full_unstemmed Description of the Use of Plasma Exchange in Dogs With Cutaneous and Renal Glomerular Vasculopathy
title_short Description of the Use of Plasma Exchange in Dogs With Cutaneous and Renal Glomerular Vasculopathy
title_sort description of the use of plasma exchange in dogs with cutaneous and renal glomerular vasculopathy
topic Veterinary Science
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060235/
https://www.ncbi.nlm.nih.gov/pubmed/30073173
http://dx.doi.org/10.3389/fvets.2018.00161
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