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yWhat is an autoimmune disease?

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pathologypathology

CELL

Co ple e tpathway

Ag

Ab

Ag-Abcomplex

AB MEDIATED

CYTOTOXICITYCELL LYSIS

Ab ediatedreceptor bi di gofphagocytic cell

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ETIOLOGYETIOLOGY

Infectious agents

Vaccines,drugs

Food & envmt

allergens etc

EXTFACTORS

Breed predispositionGENETICFACTORS

AU

T

O

I

M

MU

N

E

D

IS

E

A

S

E

S

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AUTOIMMUNE HEMOLYTICAUTOIMMUNE HEMOLYTICANAEMIA (AIHA)ANAEMIA (AIHA)

&&

THROMBOCYTOPENIATHROMBOCYTOPENIA

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PERACUTE ACUTE

y Middle aged, larger breeds

y Acute depression

y Variable icterus & Hburia

y Nonresp anaemia- become

resp in 3-5 daysy Thrombocytopenia &

thrombotic phenomena

y Prognosis poor even ith

prompt therapy

y

Cocker spanielsy Pallor , fatigue

y Icterus less common

y Hepatospleenomegaly

y WBC o due to BMhyperplasia

y Responds ell toglucocorticoids/cytotoxic

drugs

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DIAGNOSISHematology

y

moderate to severeregenerative anemia

y anisocytosis

y

polychromasiay high reticulocyte count (> 120G/L)

y increased numbers of nucleated RBC

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rouleaux spherocyte

o serum total bilirubin concentrationLeukocytosis ( ith neutrophilic left shift and toxic changes)

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COOMBS TEST

(DAT)

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TREATMENTSUPPORTIVE THERAPY

y Cage rest

y Blood transfusion- controversial!

y Aspirin- 0.5 mg/kg

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INITIAL IMMUNOSUPPRESSIVE THERAPY

y Methylprednisolone:2-4 mg/kg od

follo ed by pred@ 1-2 mg/kg po bid fora minm of 7-10 days

y Weekly monitoring until anaemia resolves

y Tapered by 50% every 2 ks over a

3month pd

(hematocrit>30%,-ve DAT)

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y OTHER TREATMENT

y doxycycline@10 mg/kg for 28 d in

endemic areas

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MYASTHENIA GRAVISMYASTHENIA GRAVIS

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y ACQUIRED MG

y 2-3 years of age or older than 9 years

y less common in intact male dogs

(possibly due to testosterone influence)

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TREATMENT

y Oral long-acting ACh-Esterase Inhibitor:

Pyridostigmine bromide 1-3 mg/kg

Orally q 8-12 hrs.

available as MYESTIN 30mg,60mg tab

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AUTOIMMUNE SKIN DISEASESAUTOIMMUNE SKIN DISEASES

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PEMPHIGUS COMPLEXPEMPHIGUS COMPLEX

y Pemphigus foliaceous

y pemphigus vulgaris

y pemphigus vegetans

y Pemphigus erythematosis

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DISCOID LUPUSDISCOID LUPUS

y benign form of SLE.

y Lesions are usually confined to the face

y depigmentation,

y erythema

y excess scale over the nasal region.

y ulceration

y UV light deteriorates the condition

y Breed predispositions-German shepherds

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y Shifting lameness

y Polymyositis

y glomerulonephritis

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TREATMENTTREATMENT

y Systemic glucocorticoids/topicalhydrocortisone sprays

(e.g. Cortavance)

y Azathiopriney Gold therapy (chrysotherapy)

y Cyclophosphamide

@2.2mg/kg/day poavailable as CYPHOS 200mg,500mg,1g vial

ENDOXAN-ASTA tab 50mg

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CONCLUSIONCONCLUSION

y Goal

y

What e can do?

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