Journal article Open Access
Manev, Iliyan; Marincheva, Victoria
Immune-mediated hemolytic anemia (IMHA) is a common autoimmune disorder in dogs. It affects both sexes but occurs more often in female, middle-aged animals. IMHA can be idiopathic (primary) or secondary to infectious, neoplastic and autoimmune disorders. There is an acute regenerative anemia with accompanying hypoxia. Destruction of erythrocytes can be intravascular (as a result of complement system activation) or extravascular (removal of antibody-coated red blood cells by the macrophages in the liver and spleen). Diagnosis is based on the presence of anemia, in vitro autoagglutination, positive direct antiglobulin test (Coomb`s test), detection of spherocytes. It is crucial to exclude possible secondary causes. The treatment protocol aims to cease cell destruction by high doses of corticosteroids, aggressive supportive care and long-term application of immunosuppressive drug combinations. Still lethality is high because of complications (pulmonary thromboembolism, DIC), medication resistance, relapses.
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