blok 7 bloed en bloedvormende organen - VETserieus

aanvullingen vanuit HC13
Immune-mediated haemolytic anaemia (IMHA). In IMHA red blood cells are destroyed within the
circulation or extravascular as a consequence of anti-erythrocyte antibody production. Can be primary or
secondary in nature.60 to 75% of IMHA cases in dogs are thought to be primary, or idiopathic in origin.
Secondary IMHA occurs when there is an underlying disease that leads to attachment of
immunoglobulins to erythrocytes such as neoplastic and chronic infectious diseases,
exposure to drugs, toxins, and vaccines.
Therapy Blood transfusions were given when judged necessary by the attending clinician. Individual
changes in dose or duration of either prednisolone or azathioprine treatment were made based on the
response to therapy and the occurrence of side effects.
Conclusion Mortality in canine IIMHA within the first 2 weeks is 20%. Long-term prognosis after 14 days
is good Mortality within the first 2 weeks can be predicted based on an increase in urea, the presence of
icterus and petechiae. In canine IIMHA an increase in urea, a decrease in thrombocytes and an increase
in bands, and the presence of petechiae predict death.
aanvullingen vanuit HC16
Diagnose: primaire ontstekingsreacties (innate immuun respons): NSAIDs (of antihistaminica bij
allergische reacties)
Diagnose: Adaptieve immuun response: Glucocorticoiden, immunosupressants (auto-immuun
processen)
cortico's:
• Remmen de synthese van cytokinen (transcriptie) --> Remmen fosfolipase A2 (remming
prostaglandinesynthese)
• Remming van de activatie van ontstekingscellen
- emmen IL-1/ IL-2: cellulaire afweermechanismen = immuunsuppressie
• Remmen COX-2 en 5-LOX
Indicaties:
• Acute Onstekingsremming en auto-immuunziekten
BIJWERKINGEN
• Lipolyse (M.Cushing)
• Spierafbraak (remming eiwitsynthese)
• remming wondgenezing
• immuunosuppressie
• ketogeen - diabetogeen