犬埃文斯综合征并发癫痫的诊治  

Diagnosis and Treatment of Canine Evans Syndrome Complicated with Epilepsy

作　　者：冯芷珊 阮丽[2] 傅梦竹 杨名 张博闻 苏畅 吴定洲 倪浩然 朱超兰 朱思羽 林雨睿 周雪影 FENG Zhi-shan;RUAN Li;YANG Ming;FU Meng-zhu;SU Chang;WU Ding-zhou;NI Hao-ran;ZHU Chao-lan;ZHU Si-yu;LIN Yu-rui;ZHOU Xue-ying(College of Veterinary Medicine,China Agricultural University,Beijing,100193,China;Veterinary Teaching Hospital of China Agricultural University,Beijing,100193,China)

机构地区：[1]中国农业大学动物医学院,北京100193 [2]中国农业大学动物医院,北京100193

出　　处：《动物医学进展》2025年第6期125-131,共7页Progress In Veterinary Medicine

摘　　要：在国内首次报道犬埃文斯综合征并发癫痫的诊断、治疗及转归过程。9月龄的雌性萨摩耶犬因丛集性癫痫发作就诊,犬有埃文斯综合征病史,输血并使用泼尼松龙后好转,但降低剂量过程中丛集性癫痫发作。血常规及涂片检查显示中度再生性贫血,中性粒细胞核左移及中毒性变化,血清生化检查显示高胆红素血症,肝酶、胆汁酸显著升高,诊断为类固醇诱导性肝病及复发免疫介导性溶血性贫血。联用地塞米松、环孢素、硫唑嘌呤与阿糖胞苷,配合抗癫痫药物、免疫球蛋白,犬贫血与肝病改善,有效控制癫痫发作。后续进行的磁共振成像与脑脊液分析结果提示癫痫发作由颅内肿物与脑穿通畸形导致,高度怀疑肉芽肿性脑膜脑炎(GME)。临床上埃文斯综合征犬出现癫痫发作极为罕见,论文对兽医临床相关疾病的诊断和治疗具有参考价值。This is the first case report for the diagnosis,treatment and outcome of a canine Evans syndrome complicated with epilepsy.A 9-month-old female Samoyed presented with Evans syndrome history,improved with blood transfusion and prednisolone,but developed cluster seizures during dose reduction.Complete blood count and blood smear microscopic examination showed moderate regenerative anemia,left shift and toxic change in neutrophils.Serum biochemical examination showed hyperbilirubinemia and significantly elevated liver enzyme and bile acid.The canine was diagnosed with steroid-induced liver disease and recurrent immune-mediated hemolytic anemia.Treatment included dexamethasone,cyclosporine,azathioprine,cytarabine,antiepileptic drugs and human intravenous immunoglobulin.The dog’s anemia and liver disease were improved,and epilepsy was effectively controlled.Subsequent magnetic resonance imaging and cerebrospinal fluid analysis indicated that the epileptic seizure was caused by intracranial mass and brain porencephaly,highly suspected of granulomatous meningoencephalitis(GME).Evans syndrome presented with seizures is rare in clinical practice,this report has reference value and significance for the diagnosis,treatment of related diseases in veterinary clinic.

关 键 词：犬 免疫介导性溶血性贫血 埃文斯综合征 癫痫 肉芽肿性脑膜脑炎 

分 类 号：S858.292[农业科学—临床兽医学]