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Suciu A, Starybrat D, Gil-Morales C, Matson H, Jepson R, Williams M, Lyraki M, McMahon L, Nerhagen S, Veitch A, Llewellyn E. Clinical findings, treatment and outcome of trapped neutrophil syndrome in Border Collies: 12 cases (2011-2022). J Small Anim Pract 2024; 65:560-568. [PMID: 38622907 DOI: 10.1111/jsap.13726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/24/2024] [Accepted: 03/02/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES This study aimed to evaluate clinical signs, diagnostic findings, treatment administered and short- (survival to 28 days) and long-term prognosis (survival >6 months) in dogs diagnosed with trapped neutrophil syndrome. MATERIALS AND METHODS Medical records of 12 dogs (10 Border Collies and two Border Collie Crossbreeds) homozygous for VPS13B gene mutation causing trapped neutrophil syndrome from seven veterinary institutions between January 2011 and June 2022 were evaluated retrospectively. RESULTS The most common clinical signs at the time of diagnosis were pyrexia, abnormal gait and gastrointestinal signs. Concurrent metaphyseal osteopathy and immune-mediated polyarthritis were common. Seven dogs had a segmented neutrophil count below, four dogs within and one dog above the analyser reference interval at presentation. Two dogs had a septic source identified and both were additionally identified to be homozygous mutant positive on DNA testing by polymerase chain reaction (PCR) for canine cyclic neutropenia. All dogs received at least one antimicrobial agent and 10 dogs received treatment with prednisone or prednisolone (median starting dose 1 mg/kg/day; range 0.5 to 2.5 mg/kg/day). Nine dogs were alive at 28 days and six dogs were alive at 6 months post-diagnosis. CLINICAL SIGNIFICANCE Trapped neutrophil syndrome should be suspected in young Border Collies with pyrexia, lameness and gastrointestinal signs. Neutropenia may not always be present and long-term survival is possible. A septic focus was not commonly identified in our population; however, our results suggest that if identified, testing for concurrent canine cyclic neutropenia should be considered.
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Affiliation(s)
- A Suciu
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, EH25 9RG, UK
| | - D Starybrat
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, EH25 9RG, UK
| | - C Gil-Morales
- School of Veterinary Sciences, University of Bristol, Bristol, UK
| | - H Matson
- Department of Clinical Science and Services, Royal Veterinary College, Queen Mother Hospital for Animals, Hawkshead Lane, North Mymms, Herts, London, AL9 7TA, UK
| | - R Jepson
- Department of Clinical Science and Services, Royal Veterinary College, Queen Mother Hospital for Animals, Hawkshead Lane, North Mymms, Herts, London, AL9 7TA, UK
| | - M Williams
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - M Lyraki
- School of Veterinary Sciences, University of Bristol, Bristol, UK
| | - L McMahon
- Anderson Moores Veterinary Specialists, The Granary, Bunstead Barns, Poles Lane, Hursley, Winchester, Hampshire, SO21 2LL, UK
| | - S Nerhagen
- Faculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Ås, Norway
| | - A Veitch
- Dryfe Vets Ltd, 1 Mains Street, Lockerbie, DG11 2DG, UK
| | - E Llewellyn
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, EH25 9RG, UK
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2
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Perry KM, Enders BD, Negrão Watanabe TT. Refractory shock, hypercoagulability, and multiorgan thrombosis associated with hypertrophic osteodystrophy in a dog. J Vet Emerg Crit Care (San Antonio) 2023; 33:257-262. [PMID: 36799891 DOI: 10.1111/vec.13280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/07/2022] [Accepted: 02/26/2022] [Indexed: 02/18/2023]
Abstract
OBJECTIVE To describe the clinical findings and case progression in a dog presenting with severe systemic inflammatory response, refractory shock, progressive metabolic acidosis, and respiratory failure that was ultimately diagnosed with hypertrophic osteodystrophy (HOD). CASE SUMMARY A 4-month-old male intact Mastiff presented with a 24-hour history of lethargy and generalized ostealgia. On examination, the dog was recumbent, febrile, and tachycardic with pain on palpation of the abdomen, right femur, and mandible. Appendicular joint radiographs showed changes consistent with osteochondrosis and ulnar-retained cartilaginous cores, with no overt evidence of HOD. Initial treatment included IV fluid therapy, multimodal analgesia, and broad-spectrum antimicrobials. Vasopressor therapy was initiated following hemodynamic decompensation. Synovial fluid cytological analysis and culture revealed nonseptic suppurative inflammation and no bacterial growth, respectively. Blood and urine cultures also yielded no growth. Viscoelastic testing was consistent with hypercoagulability. The dog initially had a metabolic acidosis with appropriate respiratory compensation that progressed to a mixed metabolic and respiratory acidosis despite aggressive therapies that included antimicrobials, vasopressors, positive inotropes, and corticosteroids. Humane euthanasia was elected approximately 32 hours after admission. Necropsy yielded a diagnosis of HOD. NEW OR UNIQUE INFORMATION PROVIDED This is the first report detailing the occurrence of refractory shock and hypercoagulability associated with HOD in a dog without evidence of another identified comorbidity. HOD should be considered in any young, large-breed dog with generalized ostealgia and signs of systemic illness, even in the absence of classic radiographic abnormalities. Further investigation of coagulation status in dogs with HOD and a secondary systemic inflammatory response is warranted.
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Affiliation(s)
- Kayla M Perry
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Brittany D Enders
- Small Animal Emergency and Triage Services, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
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Robertson AL, Black VL, Villedieu E, Clarke KE, Faux I, Major A, Adamantos S. Presenting signs and clinical outcome in dogs with metaphyseal osteopathy: 39 cases (2009-2018). J Small Anim Pract 2023; 64:35-42. [PMID: 36123814 PMCID: PMC10087536 DOI: 10.1111/jsap.13554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 07/29/2022] [Accepted: 08/12/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To describe the presenting signs, concurrent conditions, treatment and outcome of dogs with metaphyseal osteopathy. MATERIALS AND METHODS Multi-centre retrospective review of medical records from January 2009 to September 2018 at four referral centres to identify dogs with a radiographic diagnosis of metaphyseal osteopathy. RESULTS Thirty-nine dogs were identified. The median age at onset was 14 weeks old (range, 8 to 32 weeks old). There was a higher proportion of male dogs (29 of 39 male entire, nine of 39 female entire, one of 39 female neutered and no male neutered dogs). Where information was available, median time from the most recent vaccination was 20 days (range, 2 to 144 days). The most commonly recorded clinical signs were pyrexia (34 of 39), lethargy (32 of 39), pain (30 of 39), and being non-ambulatory (17 of 39). Thirty-five dogs required hospitalisation for analgesia and supportive care, 19 of 39 were discharged on prednisolone (median dose 2.0 mg/kg/day; range, 0.9 to 2.6 mg/kg/day), 18 of 39 were discharged on non-steroidal anti-inflammatories, two of 39 did not receive NSAIDs or prednisolone at any time point. The median duration of hospitalisation for those admitted was 5 days (range, 1 to 21 days). Where follow-up was available, relapse occurred in eight of 25 cases before reaching skeletal maturity. At the time of metaphyseal osteopathy diagnosis, five of 39 cases had concurrent conditions. Where follow-up was available, four of 25 developed future immune-mediated conditions. CLINICAL SIGNIFICANCE Metaphyseal osteopathy should be considered in non-ambulatory painful young dogs. Some dogs developed future immune-mediated conditions, which may support the hypothesis that metaphyseal osteopathy is an autoinflammatory bone disorder. Further studies with a larger cohort are required to determine the clinical significance of this.
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Affiliation(s)
- A L Robertson
- Bristol Veterinary School, University of Bristol, Bristol, BS8 1TH, UK.,The Ralph Veterinary Referral Centre, The Ralph Veterinary Referral Centre, Marlow, SL7 1YG, UK
| | - V L Black
- Bristol Veterinary School, University of Bristol, Bristol, BS8 1TH, UK
| | - E Villedieu
- Willows Veterinary Centre and Referral Service, Willows Veterinary Centre and Referral Service, Shirley, B90 4NH, UK
| | - K E Clarke
- Davies Veterinary Specialists, Davies Veterinary Specialists, Shillington, SG5 3HR, UK
| | - I Faux
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, EH25 9RG, UK
| | - A Major
- Langford Vets Small Animal Referral Hospital, University of Bristol, Langford, BS40 5DU, UK
| | - S Adamantos
- Langford Vets Small Animal Referral Hospital, University of Bristol, Langford, BS40 5DU, UK
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4
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Johnson KL, Craig LE, Wilson S, McLarty E, Hespel AM. Radiographic evidence of metaphyseal sclerosis secondary to canine distemper virus: 4 cases in juvenile dogs. J Vet Intern Med 2022; 36:1303-1311. [PMID: 35656875 PMCID: PMC9308435 DOI: 10.1111/jvim.16453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 05/10/2022] [Indexed: 11/27/2022] Open
Abstract
Background Metaphyseal sclerosis secondary to canine distemper virus has been described histopathologically, but its radiographic appearance has not been described. Objectives Describe the radiographic appearance of metaphyseal sclerosis secondary to canine distemper virus in juvenile dogs as distinct from metaphyseal osteopathy (formerly called hypertrophic osteodystrophy). Animals Four dogs (2 intact females and 2 intact males) between 2.5 and 4 months of age presented to 2 different veterinary teaching hospitals. Methods Retrospective case series in which definitive diagnosis of canine distemper virus based on antemortem positive reverse transcription‐polymerase chain reaction (RT‐PCR) result or necropsy was required. Results All 4 dogs were presented for evaluation of neurologic abnormalities, respiratory signs, and lethargy; 2 dogs had gastrointestinal signs and ocular abnormalities. Radiographs on all patients featured multifocal, symmetric, metaphyseal sclerosis, with no evidence of lysis or changes to the adjacent growth plate. The metaphyseal sclerosis was most apparent at the proximal humeral diaphyses and other included long bones. Diagnosis of distemper was confirmed by necropsy (2 of 4 dogs) or positive RT‐PCR results (2 of 4 dogs). Three dogs were euthanized because of progressive illness, and 1 dog was lost to follow‐up. Conclusion and Clinical Importance Identification of metaphyseal sclerosis on radiographs during diagnostic evaluation of young dogs should lead to a clinical suspicion of canine distemper virus infection. Sclerosis identified secondary to canine distemper virus is distinct from the necrosis and inflammation of metaphyseal osteopathy.
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Affiliation(s)
- Kryssa L Johnson
- Department of Radiology and Diagnostic Imaging, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, USA
| | - Linden E Craig
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, USA
| | - Sabrina Wilson
- Diagnostic Imaging Service, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Ehren McLarty
- Diagnostic Imaging Service, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Adrien-Maxence Hespel
- Department of Radiology and Diagnostic Imaging, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, USA
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5
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Selman J, Towle Millard H. Hypertrophic osteodystrophy in dogs: diagnosis and treatment. J Small Anim Pract 2021; 63:3-9. [PMID: 34490906 DOI: 10.1111/jsap.13413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/16/2021] [Accepted: 07/27/2021] [Indexed: 12/14/2022]
Abstract
Hypertrophic osteodystrophy is an uncommon orthopaedic disease that affects young, growing dogs. Aetiology is currently unknown; however, several unproven etiologies have been theorised in the literature including canine distemper virus, previous vaccination, hereditary causes and auto-immune disorders. Affected animals often present with varying degrees of lameness, lethargy, pyrexia and/or distal metaphyseal swelling of affected limbs. An index of suspicion is based on clinical signs. Confirmation is obtained with radiographs of the affected limb(s) by the presence of a "double physis," or a radiolucent line that is parallel to the physis. Treatment varies depending on degree affected, but generally consists of anti-inflammatory steroids, pain medications, gastrointestinal support, nutritional management and appropriate supportive care. Critically affected patients require intensive monitoring and more aggressive supportive care for prevention of life-threatening sequalae. Prognosis is very favourable with mildly and moderately affected patients, but good to guarded in severely affected patients.
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Affiliation(s)
- J Selman
- Small Animal Surgery, BluePearl Veterinary Partners, Overland Park, Kansas, USA
| | - H Towle Millard
- Small Animal Surgery, BluePearl Veterinary Partners, Overland Park, Kansas, USA
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6
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Bergmann M, Freisl M, Hartmann K. [Prevention of canine parvovirosis - Part 3: Vaccine-associated adverse events]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2021; 49:294-299. [PMID: 34425608 DOI: 10.1055/a-1543-4632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Although nowadays vaccines, especially those against canine parvovirus (CPV), are considered to be safe, vaccine-associated adverse events (VAAEs) can occur in rare cases. Some VAAEs are mild and manifest shortly (within a few days) after vaccination (e. g. gastrointestinal signs, fever, reduced general condition, lymphadenopathy). These signs are likely a result of vaccine virus replication and indicate a good immune response. Anaphylactic reactions can also occur promptly following vaccine administration and might be life threatening. Affected dogs show clinical signs such as edema, salivation, vomiting, diarrhea, hypotension, and/or shock. Since it is often unclear which component of the vaccine carries responsibility for the anaphylactic reaction it is important to limit future vaccinations of these dogs to indispensable components only. When revaccination is unavoidable, e. g. because antibodies against CPV cannot be detected, combined vaccines should not be used and CPV (and other components, if needed) should preferably be vaccinated separately. Changing the vaccine manufacturer might also prevent further anaphylactic reactions. Finally, there are VAAEs occurring after a prolonged period of time. In dogs, it is discussed that autoimmune diseases, such as immune-mediated hemolytic anemia (IMHA), can be a consequence of excessive vaccination or in the least be triggered by vaccination. Numerous dogs with IMHA are reported to have a history of receiving a vaccination within a few weeks before the onset of clinical sings. In such dogs, further vaccinations should generally be avoided.
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Affiliation(s)
- Michèle Bergmann
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
| | - Monika Freisl
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
| | - Katrin Hartmann
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
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7
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Kieves NR. Juvenile Disease Processes Affecting the Forelimb in Canines. Vet Clin North Am Small Anim Pract 2021; 51:365-382. [PMID: 33558013 DOI: 10.1016/j.cvsm.2020.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Several juvenile diseases affect the canine forelimb. The most common are hypertrophic osteodystrophy, panosteitis, and retained cartilaginous core. Panosteitis and hypertrophic osteodystrophy tend to be self-limiting, with a good long-term prognosis, although severe cases can develop. These diseases may recur during growth. Severe cases of hypertrophic osteodystrophy can lead to angular limb deformities and may even be fatal. Retained cartilaginous cores can be benign with no evidence of clinical signs and be found incidentally on radiographs. However, if they disrupt the distal ulnar physis, angular limb deformities may persist requiring surgical intervention with a corrective osteotomy.
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Affiliation(s)
- Nina R Kieves
- Small Animal Orthopedic Surgery, The Ohio State University, 601 Vernon L Tharp Street, Columbus, OH 43210, USA.
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8
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Chronic nonbacterial osteomyelitis (CNO) and chronic recurrent multifocal osteomyelitis (CRMO). J Transl Autoimmun 2021; 4:100095. [PMID: 33870159 PMCID: PMC8040271 DOI: 10.1016/j.jtauto.2021.100095] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/22/2021] [Accepted: 03/10/2021] [Indexed: 01/01/2023] Open
Abstract
Chronic nonbacterial osteomyelitis (CNO) is an inflammatory bone disorder that most frequently affects children and adolescents. Chronic recurrent multifocal osteomyelitis (CRMO) is a severe form of CNO, usually characterized by symmetrical inflammatory bone lesions and its waxing and waning character. Sometimes severe and chronic pain can significantly affect the quality of life and psychosocial development of individuals affected. In the absence of prospectively tested and widely accepted diagnostic criteria or disease biomarkers, CNO remains a diagnosis of exclusion, and infections, malignancy and other differentials require consideration (1). The pathophysiology of CNO is not fully understood, but imbalanced cytokine expression and increased inflammasome activation in monocytes from CNO patients contribute to a pro-inflammatory phenotype that contributes to bone inflammation (2). Currently, no medications are licensed for the use in CNO. Most patients show at least some response to nonsteroidal anti-inflammatory drugs, others require more aggressive treatment that can include corticosteroids, cytokine-blocking agents and/or bisphosphonates (3). While under the care of an experienced team and sufficient treatment, the prognosis is good, but some patients will develop sequalae which can include vertebral compression fractures (1). CNO is an autoinflammatory bone disorder mostly affecting children and adolescents. Dysregulated cytokine expression and pathological activation of inflammasomes play a central role. Treatment is based on experience from case series and expert consensus treatment plans. Understanding the exact molecular pathophysiology will allow patient stratification and individualized treatment.
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9
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Majeed Syndrome: A Review of the Clinical, Genetic and Immunologic Features. Biomolecules 2021; 11:biom11030367. [PMID: 33670882 PMCID: PMC7997317 DOI: 10.3390/biom11030367] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 12/19/2022] Open
Abstract
Majeed syndrome is a multi-system inflammatory disorder affecting humans that presents with chronic multifocal osteomyelitis, congenital dyserythropoietic anemia, with or without a neutrophilic dermatosis. The disease is an autosomal recessive disorder caused by mutations in LPIN2, the gene encoding the phosphatidic acid phosphatase LIPIN2. It is exceedingly rare. There are only 24 individuals from 10 families with genetically confirmed Majeed syndrome reported in the literature. The early descriptions of Majeed syndrome reported severely affected children with recurrent fevers, severe multifocal osteomyelitis, failure to thrive, and marked elevations of blood inflammatory markers. As more affected families have been identified, it has become clear that there is significant phenotypic variability. Data supports that disruption of the phosphatidic acid phosphatase activity in LIPIN2 results in immune dysregulation due to aberrant activation of the NLRP3 inflammasome and overproduction of proinflammatory cytokines including IL-1β, however, these findings did not explain the bone phenotype. Recent studies demonstrate that LPIN2 deficiency drives pro-inflammatory M2-macrophages and enhances osteoclastogenesis which suggest a critical role of lipin-2 in controlling homeostasis at the growth plate in an inflammasome-independent manner. While there are no approved medications for Majeed syndrome, pharmacologic blockade of the interleukin-1 pathway has been associated with rapid clinical improvement.
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10
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Zhao Y, Ferguson PJ. Chronic non-bacterial osteomyelitis and autoinflammatory bone diseases. Clin Immunol 2020; 216:108458. [PMID: 32389739 PMCID: PMC7338233 DOI: 10.1016/j.clim.2020.108458] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 05/04/2020] [Accepted: 05/04/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Yongdong Zhao
- Department of Pediatrics, University of Washington, Seattle, WA, United States of America
| | - Polly J Ferguson
- Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA, United States of America.
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11
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Hegler AK, Grooters AM, Dehghanpir SD, Gallaher RA, Gaschen LE. Trapped Neutrophil Syndrome in a Border Collie. J Am Anim Hosp Assoc 2020; 56:e56304. [PMID: 32182118 DOI: 10.5326/jaaha-ms-6981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 10 wk old female border collie was presented for hemorrhagic diarrhea and pelvic limb lameness. Examination revealed pain and effusion in multiple appendicular joints and pyrexia. Clinicopathologic testing revealed moderate neutropenia as well as nondegenerate neutrophilic inflammation in multiple joints. Radiographs showed capsular joint swelling and heterogeneous metaphyseal lucencies in the distal radius, ulna, femur, and tibia. Genetic testing confirmed a mutation in the vacuolar protein sorting-associated protein 13B gene and a diagnosis of trapped neutrophil syndrome (TNS). Within 24 hr of initiating prednisone therapy (1 mg/kg, per os, q 12 hr), the dog was afebrile and nonpainful with normal ambulation. Lameness recurred twice over the next 5 mo. At 9 mo of age, diagnostics showed severe erosive polyarthritis of both stifles with an inflammatory leukogram and arthrocentesis findings consistent with septic arthritis, and the dog died despite antibiotic therapy. This is the first case of TNS described in the North American literature, and it is unique in that we had the opportunity to document progression of radiographic abnormalities over more than 6 mo. TNS should be considered in young border collies with signs suggestive of immune-mediated polyarthritis, septic arthritis, or hypertrophic osteodystrophy, combined with neutropenia or gastrointestinal signs.
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Affiliation(s)
- Ashley K Hegler
- From Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana
| | - Amy M Grooters
- From Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana
| | - Shannon D Dehghanpir
- From Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana
| | - Rebekah A Gallaher
- From Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana
| | - Lorrie E Gaschen
- From Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana
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12
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Metaphyseal osteopathy-like disease in two sibling kittens. Vet Comp Orthop Traumatol 2015; 29:94-7. [PMID: 26603951 DOI: 10.3415/vcot-15-03-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 10/18/2015] [Indexed: 11/17/2022]
Abstract
This report describes the diagnosis and treatment of a growth plate disturbance resembling canine metaphyseal osteopathy in two, two-month-old, sibling, intact, female Domestic Shorthair cats. Clinical signs and radiographic lesions resolved spontaneously after three months. Follow-up examination at six months of age showed complete recovery and no radiographic abnormalities.
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13
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Ferguson PJ, Laxer RM. New discoveries in CRMO: IL-1β, the neutrophil, and the microbiome implicated in disease pathogenesis in Pstpip2-deficient mice. Semin Immunopathol 2015; 37:407-12. [PMID: 25894861 DOI: 10.1007/s00281-015-0488-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 03/31/2015] [Indexed: 01/22/2023]
Abstract
Chronic non-bacterial osteomyelitis (CNO), chronic recurrent multifocal osteomyelitis (CRMO) and synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome are autoinflammatory disorder(s) in which sterile osteomyelitis is frequently accompanied by inflammatory conditions of the joints, skin, or intestine. Patients with CRMO commonly have a personal or family history of psoriasis, inflammatory bowel disease, and inflammatory arthritis, suggesting shared disease pathogenesis. Work by our group and others has demonstrated that dysregulation of interleukin-1 (IL-1) signaling can drive sterile osteomyelitis in the two human monogenic forms of the disease. Recent work in the chronic multifocal osteomyelitis (cmo) mouse model demonstrates that the disease is IL-1-mediated, that neutrophils are critical effector cells and that both caspase-1 and caspase-8 play redundant roles in mediating the cleavage of pro-IL-1β into its biologically active form. Recent data in the cmo mouse demonstrate that dietary manipulation alters the cmo microbiome and can prevent the development of osteomyelitis. Further investigation is needed to determine the specific components of the diet that result in protection from disease and if this finding can be translated into a treatment for human CRMO.
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Affiliation(s)
- Polly J Ferguson
- Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, USA,
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14
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Abstract
Metaphyseal osteopathy, otherwise known as hypertrophic osteodystrophy, is a disease that causes pyrexia and lethargy accompanied by pain in the thoracic and pelvic limbs of rapidly growing large-breed dogs. While metaphyseal osteopathy has been descibed in association with slipped capital femoral epiphysis in cats, it has not previously been reported as a cause of limb pain and pyrexia in this species. A 7-month-old British Shorthair cat presented with a 1 month history of pyrexia, lethargy and pain in all limbs. Investigation included radiographs of the limbs and chest, abdominal ultrasound, serum biochemical analysis, haematology, bone biopsy, joint fluid aspiration and cytology. Findings were consistent with a diagnosis of metaphyseal osteopathy. The cat's clinical signs resolved following the administration of prednisolone. Symptoms recurred 1 month after the cessation of prednisolone therapy, but resolved when administration was resumed.
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Affiliation(s)
- Carl Adagra
- School of Veterinary and Biomedical Sciences, James Cook University, Townsville, QLD, Australia
| | - Derek Spielman
- Faculty of Veterinary Science, University of Sydney, Sydney, NSW, Australia
| | | | - Darren J Foster
- Eastside Vet Emergency & Specialists, Rose Bay, NSW, Australia
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15
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Hypertrophic Osteodystrophy in Two Red Wolf ( Canis rufus) Pups. Case Rep Vet Med 2015. [DOI: 10.1155/2015/970742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A 6-month-old red wolf (Canis rufus) pup presented for evaluation of progressive thoracic and pelvic limb lameness, joint swelling, and decreased body condition. Radiographic evaluation revealed medullary sclerosis centered at the metaphyses of multiple long bones, well-defined irregular periosteal proliferation, and ill-defined lucent zones paralleling the physes, consistent with hypertrophic osteodystrophy (HOD). Biopsies of affected bone revealed medullary fibrosis and new bone formation. The pup improved following treatment with nonsteroidal anti-inflammatories, opioids, and supportive care over the course of 4 weeks. Metaphyseal periosteal bone proliferation persisted until the animal was humanely euthanized several years later for poor quality of life associated with bilateral cranial cruciate ligament rupture. A second red wolf pup of 4.5 months of age presented for evaluation of lethargy, kyphotic posture, and swollen carpal and tarsal joints. Radiographs revealed bilateral medullary sclerosis and smooth periosteal reaction affecting multiple long bones, suggestive of HOD. Further diagnostics were not pursued in this case to confirm the diagnosis, and the clinical signs persisted for 4 weeks. In light of these two case reports, HOD should be recognized as a developmental orthopedic disease in growing red wolves.
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16
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Hill M, Scudder CJ, Glanemann B, Drees R. Hypertrophic osteodystrophy in a dog imaged with CT. VETERINARY RECORD CASE REPORTS 2015. [DOI: 10.1136/vetreccr-2014-000155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
| | | | - Barbara Glanemann
- Queen Mother Hospital for AnimalsRoyal Veterinary CollegeHatfieldHertfordshireUK
| | - Randi Drees
- Queen Mother Hospital for AnimalsRoyal Veterinary CollegeHatfieldHertfordshireUK
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Greenwell CM, Brain PH, Dunn AL. Metaphyseal osteopathy in three Australian Kelpie siblings. Aust Vet J 2014; 92:115-8. [PMID: 24673138 PMCID: PMC7159709 DOI: 10.1111/avj.12162] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2013] [Indexed: 11/28/2022]
Abstract
CASE REPORT Metaphyseal osteopathy (MO) was diagnosed in three Australian Kelpie puppies that were presented for veterinary assessment of lameness. The three puppies were siblings. Each was from a different litter by the same breeding pair. The puppy in case one was seen by the authors, and the puppies in cases two and three were patients at other veterinary hospitals. However, the medical records and radiographs were examined and reviewed for this report. Radiographic investigation of the lameness revealed pathognomonic appearance of MO affecting the metaphyseal region of the long bones in all three puppies. The diagnosis was confirmed on histopathology in one patient. CONCLUSION MO is considered a disease of large and giant-breed dogs, being rarely reported in non-large-breed dogs, and has not been reported in the Australian Kelpie, which is considered a medium-breed dog. This case series suggests a previously unreported breed predisposition to MO in the Australian Kelpie.
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Affiliation(s)
- C M Greenwell
- University of Sydney Veterinary Teaching Hospital, Camden, NSW, Australia
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Autoinflammatory bone disorders: update on immunologic abnormalities and clues about possible triggers. Curr Opin Rheumatol 2014; 25:658-64. [PMID: 23917160 DOI: 10.1097/bor.0b013e328363eb08] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW To provide an update on the genetics and immunologic basis of autoinflammatory bone disorders including chronic recurrent multifocal osteomyelitis including the monogenic forms of the disease. RECENT FINDINGS Ongoing research in murine, canine and human models of sterile bone inflammation has solidified the hypothesis that sterile bone inflammation can be genetically driven. Mutations in Pstpip2, LPIN2 and IL1RN have been identified in monogenic autoinflammatory bone disorders that have allowed more detailed dissection of the immunologic defects that can produce sterile osteomyelitis. Recent studies in murine chronic multifocal osteomyelitis, deficiency of the interleukin-1 receptor antagonist (DIRA), Majeed syndrome and SAPHO syndrome reveal abnormalities in innate immune system function. IL-1 pathway dysregulation is present in several of these disorders and blocking IL-1 therapeutically has resulted in control of disease in DIRA, Majeed syndrome and in some cases of SAPHO and CRMO. Basic research demonstrates the importance of the innate immune system in disease pathogenesis and offers clues about potential disease triggers. SUMMARY Research and clinical data produced over the last several years support the important role of innate immunity in sterile osteomyelitis. Based on what has been learned in the monogenic autoinflammatory bone disorders, IL-1 is emerging as an important pathway in the development of sterile bone inflammation.
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Hedrich CM, Hofmann SR, Pablik J, Morbach H, Girschick HJ. Autoinflammatory bone disorders with special focus on chronic recurrent multifocal osteomyelitis (CRMO). Pediatr Rheumatol Online J 2013; 11:47. [PMID: 24359092 PMCID: PMC3881012 DOI: 10.1186/1546-0096-11-47] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 12/14/2013] [Indexed: 01/19/2023] Open
Abstract
Sterile bone inflammation is the hallmark of autoinflammatory bone disorders, including chronic nonbacterial osteomyelitis (CNO) with its most severe form chronic recurrent multifocal osteomyelitis (CRMO). Autoinflammatory osteopathies are the result of a dysregulated innate immune system, resulting in immune cell infiltration of the bone and subsequent osteoclast differentiation and activation. Interestingly, autoinflammatory bone disorders are associated with inflammation of the skin and/or the intestine. In several monogenic autoinflammatory bone disorders mutations in disease-causing genes have been reported. However, regardless of recent developments, the molecular pathogenesis of CNO/CRMO remains unclear.Here, we discuss the clinical presentation and molecular pathophysiology of human autoinflammatory osteopathies and animal models with special focus on CNO/CRMO. Treatment options in monogenic autoinflammatory bone disorders and CRMO will be illustrated.
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Affiliation(s)
- Christian M Hedrich
- Division of Pediatric Rheumatology and Immunology, Children's Hospital Dresden, University Medical Center Carl Gustav Carus, TU Dresden, Dresden, Germany.
| | - Sigrun R Hofmann
- Division of Pediatric Rheumatology and Immunology, Children’s Hospital Dresden, University Medical Center Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Jessica Pablik
- Division of Pathology, University Medical Center Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Henner Morbach
- Department of Pediatrics, University of Würzburg, Würzburg, Germany
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