Edema and tetraparesis in a miniature pig after allogeneic hematopoietic cell transplantation.
Edema and tetraparesis in a miniature pig after allogeneic hematopoietic cell transplantation.
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发表时间：
2012-08
影响因子：
0.8
通讯作者：
R. Crepeau;A. Matar;T. Spitzer;S. Robson;V. Pathiraja;D. Sachs;Christene A. Huang;R. Duran‐Struuck
中科院分区：
文献类型：
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作者：
R. Crepeau;A. Matar;T. Spitzer;S. Robson;V. Pathiraja;D. Sachs;Christene A. Huang;R. Duran‐Struuck
一只3月龄，12公斤，完整的小型猪在造血细胞移植后第8天出现严重的神经系统体征。该猪在移植前接受了免疫抑制方案，包括用于T细胞耗竭的抗CD 3免疫毒素、100 cGy的全身照射和45 d的环孢素。猪在移植后第7天开始表现出肿胀性病变。他还表现出意识本体感觉缺陷和躺卧增加，但精神状态正常。神经系统体征在几天内恶化;猪变得昏昏欲睡，但仍无发热。移植后第9天出现结膜肿胀，随后在第10天扩散至动物的头部、耳朵和飞节。给予止痛药治疗疼痛，环孢素水平降低。尽管采取了措施，但神经系统体征仍有进展。鉴于皮下水肿和神经系统状态恶化，怀疑大肠杆菌感染，并开始使用第三代头孢菌素治疗。临床体征在开始抗生素治疗后12小时内消退。E.大肠杆菌可引起超急性毒血症并诱发共济失调、瘫痪和躺卧。其他常见的和特异性的发现包括眼周水肿和其他皮下区域的可变水肿。粪便样本显示革兰氏阴性乳糖发酵菌落过度生长。根据临床表现、排除与水肿和神经系统疾病相容的其他潜在疾病、体格检查结果、微生物学和治疗后体征的消退，诊断猪患有水肿病。
A 3-mo-old, 12-kg, intact, miniature pig presented with severe neurologic signs on day 8 after hematopoietic cell transplantation. This pig had received an immunosuppressive regimen before transplantation that included an antiCD3 immunotoxin for T-cell depletion, 100 cGy of total-body irradiation, and cyclosporine for 45 d. The pig began exhibiting erythematous lesions on posttransplantation day 7. He also demonstrated increased conscious proprioceptive deficits and recumbency but normal mentation. Neurologic signs worsened over several days; the pig became lethargic but remained afebrile. Conjunctival swelling developed on posttransplantation day 9, which subsequently spread to the animal's head, ears and hocks by day 10. Analgesics were given for pain, and cyclosporine levels were decreased. Despite the measures taken, neurologic signs progressed. Given the worsening subcutaneous edema and neurologic status, Escherichia coli infection was suspected, and treatment with a third-generation cephalosporin was instituted. The clinical signs resolved within 12 h after the start of antibiotics. 'Shiga-like' toxin from E. coli can cause peracute toxemia and induce ataxia, paralysis, and recumbency. Other common and pathognomonic findings include periocular edema and variable edema in other subcutaneous regions. A fecal sample demonstrated an overgrowth of gram-negative, lactose-fermenting colonies. On the basis of the clinical presentation, exclusion of other potential conditions compatible with edema and neurologic diseases, physical exam findings, microbiology and the resolution of signs after therapy, the pig was diagnosed with edema disease.