[논문]Pemphigus-like Drug Reaction after Surgical Removal of a Splenic Hemangiosarcoma in a Dog

An, Sung-Ah; Wang, Hye-Bin; Han, Man-Gil; Jung, In-Sung; Song, Kun-Ho; Seo, Kyoung-Won

doi:10.17555/jvc.2017.04.34.2.103

Pemphigus-like Drug Reaction after Surgical Removal of a Splenic Hemangiosarcoma in a Dog 원문보기

Journal of veterinary clinics = 한국임상수의학회지, v.34 no.2, 2017년, pp.103 - 107

An, Sung-Ah (College of Veterinary Medicine, Chungnam National University) , Wang, Hye-Bin (College of Veterinary Medicine, Chungnam National University) , Han, Man-Gil (Royal Animal Medical Center) , Jung, In-Sung (Royal Animal Medical Center) , Song, Kun-Ho (College of Veterinary Medicine, Chungnam National University) , Seo, Kyoung-Won (College of Veterinary Medicine, Chungnam National University)

Abstract ▼ AI-Helper

A 7-year-old spayed female Shih-tzu dog with 4-month history of anorexia and weight loss was diagnosed with splenic hemangiosarcoma. One week after splenectomy, the dog developed severe, multifocal, coalescing erosive and ulcerative dermatosis with epidermal collarettes and crusts on the dorsal trunk. The dog was prescribed systemic antibiotics comprising cephradine and enrofloxacin postoperatively. Histopathological examination of skin biopsies from haired skin lesions revealed changes consistent with pemphigus foliaceus (PF). Tentative diagnosis for this patient was pemphigus-like drug reaction resulting from cephradine treatment. However, given the dog's history of hemangiosarcoma, paraneoplastic pemphigus (PNP), a rarely reported cancer-related pemphigus in dogs, was also considered for tentative diagnosis. Significant clinical remission of dermal lesions was achieved with four weeks of prednisolone and mycophenolate mofetil (MMF) treatment. Drugs were gradually tapered and eventually discontinued with concurrent reduction of dermal lesions, and no further recurrence was noted.

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문제 정의

This report presents a putative case of drug-related pemphigus foliaceus, in a dog with a history of hemangiosarcoma. We also report its successful management with oral MMF and prednisolone regime.

제안 방법

According to a recent immunomapping study, desmocollin-1 (DSC1) has been proposed as a possible autoantigen for cPF (2,15,19). The definitive diagnosis of PF is based on a combination of history, physical examination, cytology, histopathologic examination and direct immunofluorescence testing. When histopathologic changes are restricted to the outer layers of the epidermis, evidence of intercellular antibody deposition is strongly supportive but not diagnostic for PF (15).

대상 데이터

A 7-year-old spayed female Shih-tzu dog was presented with a one-week history of vomiting and four-month history of anorexia and weight loss. Physical examination revealed marked cachexia with a body condition score of 2/9 and no peripheral lymphadenopathy.

성능/효과

MMF (CellCept^®) is an effective alternative therapy for pemphigus in human and veterinary medicine (21,23). In this patient, the use of MMF along with prednisolone resulted in complete resolution of skin lesions in 4 weeks and the patient has remained in good health with no signs of recurrence in 18 months.

참고문헌 (25)

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Pemphigus-like Drug Reaction after Surgical Removal of a Splenic Hemangiosarcoma in a Dog 원문보기

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Pemphigus-like Drug Reaction after Surgical Removal of a Splenic Hemangiosarcoma in a Dog 원문보기

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