Polirradiculoneurite aguda em cães: estudo descritivo de 20 casos clínicos
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2016
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A polirradiculoneurite aguda é a forma mais comum de polineuropatia aguda em cães e é considerada o equivalente à síndrome de Guillain-Barré em Humanos. É uma doença imunomediada que afeta as raízes nervosas ventrais dos nervos espinhais, apresentando-se geralmente com um quadro agudo de lesão generalizada de neurónio motor inferior, possivelmente acompanhada de disfunção de nervos cranianos. Apesar do seu estudo em Medicina Humana ser mais aprofundado, em Medicina Veterinária muitos factos sobre a doença permanecem por esclarecer.
Este trabalho teve como objetivo caracterizar uma população de 20 cães com diagnóstico de polirradiculoneurite aguda na clínica Referência Veterinária (Portugal) durante o período entre outubro de 2011 e novembro de 2015. Em relação aos parâmetros avaliados, foram estudados os dados demográficos, a história pregressa, a apresentação clinica, os resultados dos meios complementares de diagnóstico, o tempo de recuperação e a subclassificação da doença consoante a causa. Quatro cães realizaram a terapêutica com imunoglobulina humana intravenosa.
Os resultados observados revelaram que toda a população estudada apresentou um quadro agudo não ambulatório, tendo 17 cães (85% do total) apresentado um quadro ascendente progressivo. Quanto ao exame neurológico, 19 cães (95%) apresentaram tetraparesia não ambulatória, um cão (5%) tetraplegia e toda a população apresentou fraqueza cervical. Alguns animais revelaram défices nos nervos cranianos (13, 65%) e alterações na vocalização (17, 85%), com hiporreflexia generalizada (18, 90%). Oito cães obtiveram resultados positivos para Neospora caninum e/ou Toxoplasma gondii. O tempo médio de recuperação foi de 41,07 dias. Quatro animais que realizaram tratamento com imunoglobulina intravenosa apresentaram uma média de 42,75 dias e os 11 cães que apenas fizeram tratamento de suporte apresentaram 40,45 dias de recuperação.
Neste estudo foi possível concluir que os resultados acerca da progressão da doença, apresentação clínica e tempo de recuperação são semelhantes aos referidos na bibliografia consultada. Parece observar-se também uma associação entre a doença e infeções por Neospora caninum e Toxoplasma gondii. Em relação ao tratamento com imunoglobulina intravenosa, os resultados apresentaram-se inconclusivos, carecendo de estudos futuros para um maior esclarecimento do seu papel no tratamento desta doença.
Palavras-chave: polirradiculoneurite aguda, cão, polineuropatia aguda, tetraparesia não ambulatória, hiporreflexia generalizada, imunoglobulina intravenosa.
Acute canine polyradiculoneuritis is the most common form of acute polyneuropathy recognized in dogs and it is considered the human Guillain-Barré syndrome equivalent. It is an immune-mediated disease that affects the ventral nerve roots of the spinal nerves, being normally presented with an acute generalized injury of lower motor neuron, possibly accompanied by cranial nerve dysfunction. Despite its further study in Human Medicine, in Veterinary Medicine there are a lot of information about this disease that remain unclear. The objective of this dissertation was to characterize a population comprising 20 dogs diagnosed with acute polyradiculoneuritis at Referência Veterinária (Portugal) between october 2011 and november 2015. About the evaluated parameters, it was studied the demographic data, the clinical history, the clinical presentation, the complementary diagnostic exams, the time until recovery and the disease classification according to its etiology. Four dogs were also treated with intravenous human immunoglobulin. The results showed that all the studied animals exhibited an acute non-ambulatory presentation, where 17 dogs (85%) revealed a rapid ascending progression. On the neurologic exam, 19 dogs (95%) presented non-ambulatory tetraparesis and 1 dog (5%) tetraplegia, all the population presented cervical weakness and some exhibited cranial nerve deficits (13, 65%) and changes in vocalization (17, 85%), with generalized hyporeflexia (18, 90%). Eight dogs we’re positive for Neospora caninum and/or Toxoplasma gondii. The average time until recovery was 41, 07 days. The four dogs that performed the intravenous immunoglobulin treatment exhibited an average of 42, 75 days and the 11 dogs who only received support treatment took an average of 40, 45 days to recover. In this study it was possible to conclude that the results relative to the progression of the disease, clinical presentation and recovery time we’re similar to those in the consulted bibliography. It seems to exist an association between the disease and infections caused by Neospora caninum and Toxoplasma gondii. Relatively to the intravenous immunoglobulin treatment, the results we’re inconclusive being need future studies to a better understanding of its role in the treatment of this disease.
Acute canine polyradiculoneuritis is the most common form of acute polyneuropathy recognized in dogs and it is considered the human Guillain-Barré syndrome equivalent. It is an immune-mediated disease that affects the ventral nerve roots of the spinal nerves, being normally presented with an acute generalized injury of lower motor neuron, possibly accompanied by cranial nerve dysfunction. Despite its further study in Human Medicine, in Veterinary Medicine there are a lot of information about this disease that remain unclear. The objective of this dissertation was to characterize a population comprising 20 dogs diagnosed with acute polyradiculoneuritis at Referência Veterinária (Portugal) between october 2011 and november 2015. About the evaluated parameters, it was studied the demographic data, the clinical history, the clinical presentation, the complementary diagnostic exams, the time until recovery and the disease classification according to its etiology. Four dogs were also treated with intravenous human immunoglobulin. The results showed that all the studied animals exhibited an acute non-ambulatory presentation, where 17 dogs (85%) revealed a rapid ascending progression. On the neurologic exam, 19 dogs (95%) presented non-ambulatory tetraparesis and 1 dog (5%) tetraplegia, all the population presented cervical weakness and some exhibited cranial nerve deficits (13, 65%) and changes in vocalization (17, 85%), with generalized hyporeflexia (18, 90%). Eight dogs we’re positive for Neospora caninum and/or Toxoplasma gondii. The average time until recovery was 41, 07 days. The four dogs that performed the intravenous immunoglobulin treatment exhibited an average of 42, 75 days and the 11 dogs who only received support treatment took an average of 40, 45 days to recover. In this study it was possible to conclude that the results relative to the progression of the disease, clinical presentation and recovery time we’re similar to those in the consulted bibliography. It seems to exist an association between the disease and infections caused by Neospora caninum and Toxoplasma gondii. Relatively to the intravenous immunoglobulin treatment, the results we’re inconclusive being need future studies to a better understanding of its role in the treatment of this disease.
Descrição
Orientação : João Filipe Requicha ; co-orientação : João Ribeiro
Palavras-chave
MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, VETERINÁRIA, CÃES, POLIRRADICULONEURITE AGUDA, TRATAMENTOS MÉDICOS, CASOS CLÍNICOS, DOGS, ACUTE POLYRADICULONEURITIS, MEDICAL TREATMENTS, CASE REPORTS, CANÍDEOS, CANIDS, DOENÇAS AUTOIMUNES, AUTOIMMUNE DISEASES, MEDICINA VETERINÁRIA, VETERINARY MEDICINE