RESUMEN
Hematuria is a relatively common manifestation in dogs and cats when secondary with urinary tract disorders, such as bacterial cystitis and urolithiasis, your treatment is limited to treatment of the primary cause. However, when the hematuria is persistent or capable of causing significant haematological disorders, other causes less common should to be investigated. A 12-year-old, male pit bull dog, was admitted presenting intense hematuria for the last 10 days. Laboratory tests showed intense normocytic and normochromic anemia, hypoalbuminemia and albuminuria associated with intense hematuria. The ultrasound images reveled presence of structures compatible with blood clots and increased wall thickness and irregularity of urinary bladder. The bladder wash cytology suggested chronic cystitis. Due to results of de laboratory tests and bladder US images, started treatment which antibiotic therapy associated with blood transfusions were maintained until histopathology results. During the biopsy surgery it was observed The bladder wall was thicker and richly vascularized, with normal elasticity and absence of masses or polyps on the inner and outer wall. Histopathological examination revealed thickening of the muscular layer, hemorrhage and diffuse hyperemia between muscle fibers and lamina propria, intact and ruptured capillaries filled with red blood cells, and a discrete multifoc
A hematúria é uma manifestação relativamente comum em cães e gatos quando secundária a distúrbios do trato urinário, tais como cistite bacteriana e urolitíase, sendo seu tratamento limitado à eliminação da causa primária. Entretanto, quando a hematúria é persistente ou capaz de causar distúrbios hematológicos significativos, outras causas menos comuns devem ser investigadas. Um cão, pit bull, macho de 12 anos de idade deu entrada no Hospital Veterinário da xxx com queixa principal de acentuado sangramento urinário há 10 dias. Os exames laboratoriais mostraram anemia normocítica e normo-crômica e hipoalbuminemia, associadas à proteinúria e hematúria intensa. As imagens ultrassonográficas revelaram à presença de estruturas compatíveis com coágulos sanguíneos e aumento da espessura e irregularidade da parede da bexiga, e a citologia do lavado vesical sugeriu cistite crônica. Com os resultados dos exames laboratoriais e de imagem, iniciaram-se os tratamentos com antibioticoterapia associados às transfusões sanguíneas, e o animal foi encaminhado para a biopsia de bexiga. Durante o procedimento cirúrgico, observou-se que a parede vesical apresentava-se espessa e ricamente vascularizada, com elasticidade normal e ausência de massas ou pólipos nas faces interna e externa. O exame histopatológico revelou tratar-se de cistite hemor-rágica linfoplasmocitária, uma doença rara e muito agressiva, a qual apresenta descrições semelhantes em seres humanos, mas ainda não descrita em cães.
Asunto(s)
Animales , Perros , Cistitis/microbiología , Perros , Hematuria/microbiología , InflamaciónRESUMEN
Hematuria is a relatively common manifestation in dogs and cats when secondary with urinary tract disorders, such as bacterial cystitis and urolithiasis, your treatment is limited to treatment of the primary cause. However, when the hematuria is persistent or capable of causing significant haematological disorders, other causes less common should to be investigated. A 12-year-old, male pit bull dog, was admitted presenting intense hematuria for the last 10 days. Laboratory tests showed intense normocytic and normochromic anemia, hypoalbuminemia and albuminuria associated with intense hematuria. The ultrasound images reveled presence of structures compatible with blood clots and increased wall thickness and irregularity of urinary bladder. The bladder wash cytology suggested chronic cystitis. Due to results of de laboratory tests and bladder US images, started treatment which antibiotic therapy associated with blood transfusions were maintained until histopathology results. During the biopsy surgery it was observed The bladder wall was thicker and richly vascularized, with normal elasticity and absence of masses or polyps on the inner and outer wall. Histopathological examination revealed thickening of the muscular layer, hemorrhage and diffuse hyperemia between muscle fibers and lamina propria, intact and ruptured capillaries filled with red blood cells, and a discrete multifoc
A hematúria é uma manifestação relativamente comum em cães e gatos quando secundária a distúrbios do trato urinário, tais como cistite bacteriana e urolitíase, sendo seu tratamento limitado à eliminação da causa primária. Entretanto, quando a hematúria é persistente ou capaz de causar distúrbios hematológicos significativos, outras causas menos comuns devem ser investigadas. Um cão, pit bull, macho de 12 anos de idade deu entrada no Hospital Veterinário da xxx com queixa principal de acentuado sangramento urinário há 10 dias. Os exames laboratoriais mostraram anemia normocítica e normo-crômica e hipoalbuminemia, associadas à proteinúria e hematúria intensa. As imagens ultrassonográficas revelaram à presença de estruturas compatíveis com coágulos sanguíneos e aumento da espessura e irregularidade da parede da bexiga, e a citologia do lavado vesical sugeriu cistite crônica. Com os resultados dos exames laboratoriais e de imagem, iniciaram-se os tratamentos com antibioticoterapia associados às transfusões sanguíneas, e o animal foi encaminhado para a biopsia de bexiga. Durante o procedimento cirúrgico, observou-se que a parede vesical apresentava-se espessa e ricamente vascularizada, com elasticidade normal e ausência de massas ou pólipos nas faces interna e externa. O exame histopatológico revelou tratar-se de cistite hemor-rágica linfoplasmocitária, uma doença rara e muito agressiva, a qual apresenta descrições semelhantes em seres humanos, mas ainda não descrita em cães.(AU)
Asunto(s)
Animales , Perros , Perros , Hematuria/microbiología , Cistitis/microbiología , InflamaciónRESUMEN
Positron-emission tomography/computed tomography (PET/CT) has improved cyst infection (CI) management in autosomal dominant polycystic kidney disease (ADPKD). The determinants of kidney and/or liver involvement, however, remain uncertain. In this study, we evaluated clinical and imaging factors associated with CI in kidney (KCI) and liver (LCI) in ADPKD. A retrospective cohort study was performed in hospital-admitted ADPKD patients with suspected CI. Clinical, imaging and surgical data were analyzed. Features of infected cysts were evaluated by PET/CT. Total kidney (TKV) and liver (TLV) volumes were measured by CT-derived multiplanar reconstruction. CI was detected in 18 patients who experienced 24 episodes during an interval of 30 months (LCI in 12, KCI in 10 and concomitant infection in 2). Sensitivities of CT, magnetic resonance imaging and PET/CT were 25.0, 71.4, and 95.0%. Dysuria (P<0.05), positive urine culture (P<0.01), and previous hematuria (P<0.05) were associated with KCI. Weight loss (P<0.01) and increased C-reactive protein levels (P<0.05) were associated with LCI. PET/CT revealed that three or more infected cysts were present in 70% of the episodes. TKV was higher in kidney-affected than in LCI patients (AUC=0.91, P<0.05), with a cut-off of 2502 mL (72.7% sensitivity, 100.0% specificity). TLV was higher in liver-affected than in KCI patients (AUC=0.89, P<0.01) with a cut-off of 2815 mL (80.0% sensitivity, 87.5% specificity). A greater need for invasive procedures was observed in LCI (P<0.01), and the overall mortality was 20.8%. This study supports PET/CT as the most sensitive imaging method for diagnosis of cyst infection, confirms the multifocal nature of most hospital-admitted episodes, and reveals an association of kidney and liver volumes with this complication.
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Quistes/microbiología , Hospitalización , Riñón/patología , Hígado/patología , Riñón Poliquístico Autosómico Dominante/microbiología , Brasil/epidemiología , Proteína C-Reactiva/análisis , Distribución de Chi-Cuadrado , Quistes/patología , Disuria/microbiología , Hematuria/microbiología , Técnicas para Inmunoenzimas , Hallazgos Incidentales , Hígado/microbiología , Tomografía de Emisión de Positrones , Riñón Poliquístico Autosómico Dominante/mortalidad , Riñón Poliquístico Autosómico Dominante/patología , Estudios Retrospectivos , Sensibilidad y Especificidad , Estadísticas no Paramétricas , Pérdida de PesoRESUMEN
Positron-emission tomography/computed tomography (PET/CT) has improved cyst infection (CI) management in autosomal dominant polycystic kidney disease (ADPKD). The determinants of kidney and/or liver involvement, however, remain uncertain. In this study, we evaluated clinical and imaging factors associated with CI in kidney (KCI) and liver (LCI) in ADPKD. A retrospective cohort study was performed in hospital-admitted ADPKD patients with suspected CI. Clinical, imaging and surgical data were analyzed. Features of infected cysts were evaluated by PET/CT. Total kidney (TKV) and liver (TLV) volumes were measured by CT-derived multiplanar reconstruction. CI was detected in 18 patients who experienced 24 episodes during an interval of 30 months (LCI in 12, KCI in 10 and concomitant infection in 2). Sensitivities of CT, magnetic resonance imaging and PET/CT were 25.0, 71.4, and 95.0%. Dysuria (P<0.05), positive urine culture (P<0.01), and previous hematuria (P<0.05) were associated with KCI. Weight loss (P<0.01) and increased C-reactive protein levels (P<0.05) were associated with LCI. PET/CT revealed that three or more infected cysts were present in 70% of the episodes. TKV was higher in kidney-affected than in LCI patients (AUC=0.91, P<0.05), with a cut-off of 2502 mL (72.7% sensitivity, 100.0% specificity). TLV was higher in liver-affected than in KCI patients (AUC=0.89, P<0.01) with a cut-off of 2815 mL (80.0% sensitivity, 87.5% specificity). A greater need for invasive procedures was observed in LCI (P<0.01), and the overall mortality was 20.8%. This study supports PET/CT as the most sensitive imaging method for diagnosis of cyst infection, confirms the multifocal nature of most hospital-admitted episodes, and reveals an association of kidney and liver volumes with this complication.