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Relapse Risk Factors for Immune-Mediated Hemolytic Anemia: A Retrospective Study of 163 Dogs

医学 危险系数 内科学 置信区间 胆红素 回顾性队列研究 贫血 胃肠病学 溶血性贫血
作者
S Bannister,Deborah A. Keys,Ewan Wolff
出处
期刊:Journal of The American Animal Hospital Association [American Animal Hospital Association]
卷期号:60 (5): 188-192
标识
DOI:10.5326/jaaha-ms-7371
摘要

ABSTRACT Immune-mediated hemolytic anemia (IMHA) is defined as an immune-mediated destruction of erythrocytes. Relapses are recognized, but risk factors are poorly defined. We hypothesized that a lower packed cell volume (PCV) on presentation, more transfusions during hospitalization, or a higher total bilirubin would be associated with an increased risk of relapse. IMHA was defined as a PCV less than 30% at diagnosis with two of the following identified: spherocytes, positive Coombs test, elevated total bilirubin, hemoglobinemia, or positive slide agglutination. This was a retrospective study evaluating 163 dogs between January 2005 and December 2019 from one specialty hospital. There were 13 relapses. The probability (95% confidence interval [CI]) of relapse by 3 and 12 mo was 0.05 (0.02–0.13) and 0.11 (0.06–0.22). The probability (95% CI) of relapse by 12 mo in patients who required two or more transfusions was 0.20 (0.09–0.42) compared with 0.07 (0.02–0.19) in patients who did not (P = .191). A lower PCV at diagnosis was not associated with an increased risk of relapse (hazard ratio [95% CI] 0.95 [0.86–1.04], P = .238). A higher total bilirubin was associated with a significantly increased risk of relapse (P = .003). With each increase of 1 mg/dL of total bilirubin, there was a 0.17 (95% CI 0.06–0.28) increase in the probability of relapse. These patients would likely need closer monitoring.

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