Διαγνωστική προσέγγιση της αναιμίας στα μηρυκαστικά
Λέξεις-κλειδιά:
αναιμία μηρυκαστικά διαγνωστική προσέγγιση
Περίληψη
Η αναιμία στα μηρυκαστικά είναι παθολογική κατάσταση, η οποία χαρακτηρίζεται από τη μείωση του αιματοκρίτη (Packed Cell Volume, PCV), του αριθμού των ερυθροκυττάρων (Red Blood Cells, RBCs) ή/και της αιμοσφαιρίνης. Η αναιμία χαρακτηρίζεται ως αιμολυτική, αιμορραγική ή αναιμία που οφείλεται στη μειωμένη παραγωγή των ερυθροκυττάρων, με τις δύο πρώτες κατηγορίες να χαρακτηρίζονται από αναγεννητικότητα. Η αναιμία λόγω απώλειας αίματος μπορεί να οφείλεται σε εξωπαρασίτωση ή ενδοπαρασίτωση του γαστρεντερικού σωλήνα, στο σύνδρομο του αιμορραγικού εντέρου, σε έλκη του ηνύστρου, σε έμφραξη της οπίσθιας κοίλης φλέβας καθώς και σε αιμορραγία από το ουρογεννητικό σύστημα. Ακόμη, πρωτογενείς και δευτερογενείς διαταραχές της αιμόστασης μπορεί να συνοδεύονται από αιμορραγική αναιμία. Στα αίτια της αιμολυτικής αναιμίας περιλαμβάνονται τα αιμοπαράσιτα, οι τοξίνες που παράγονται από τα Clostridium perfringens τύπου D και Clostridium hemolyticum και η λεπτοσπείρωση. Επιπλέον, ορισμένα φυτά, φάρμακα ή βαρέα μέταλλα μπορούν να προκαλέσουν αιμόλυση των ερυθροκυττάρων καθώς και η έλλειψη ιχνοστοιχείων. Η ανοσολογικής αιτιολογίας αιμολυτική αναιμία έχει επίσης αναφερθεί στα μηρυκαστικά. Η μειωμένη παραγωγή ερυθροκυττάρων οφείλεται σε έλλειψη της βιταμίνης Β12 ή του σιδήρου, καθώς και σε χρόνια νοσήματα. Παθολογικές καταστάσεις του μυελού των οστών όπως η διήθηση από φλεγμονικά ή νεοπλασματικά κύτταρα όπως και η υποπλασία ή απλασία του μυελού των οστών σχετίζονται με μειωμένη παραγωγή ερυθροκυττάρων. Για τη διαγνωστική προσέγγιση της αναιμίας μετά την εργαστηριακή επιβεβαίωση με τη γενική εξέταση του αίματος και κυρίως για την αιτιολογική διάγνωση απαιτείται η λήψη ιστορικού, η κλινική εξέταση του ζώου, και ειδικές κατά περίπτωση εξετάσεις. Κατά την κλινική εξέταση του ζώου παρατηρούνται ταχυκαρδία, ταχύπνοια, ίκτερος, ωχροί βλεννογόνοι αλλά και τα ειδικότερα συμπτώματα του υποκείμενου νοσήματος. Η τεχνική FAMACHA έχει ευρέως χρησιμοποιηθεί για την κλινική διάγνωση και τον προσδιορισμό της βαρύτητας της αναιμίας. Από τις παραμέτρους της αιματολογικής εξέτασης, πέρα από τον αιματοκρίτη, η συγκέντρωση της αιμοσφαιρίνης, οι δείκτες των ερυθροκυττάρων μέσος όγκος ερυθροκυττάρων (Mean Corpuscular Volume, MCV), και μέση συγκέντρωση αιμοσφαιρίνης (Mean Corpuscular Hemoglobin Concentration, MCHC) συμβάλλουν στην ταξινόμηση της αναιμίας. Στο επίχρισμα του αίματος αξιολογείται το σχήμα και το μέγεθος των ερυθροκυττάρων, η παρουσία εγκλείστων, καθώς και η παρουσία δικτυοερυθροκυττάρων ενδεικτικών αναγεννητικής αναιμίας. Για τη διαφοροποίηση της αναιμίας σε αναγεννητική ή μη σπανιότερα γίνεται εξέταση μυελού των οστών. Ειδικότερα, η επιβεβαίωση ανοσολογικής αιτιολογίας αναιμίας στηρίζεται στην εξέταση Coomb’s για την διαπίστωση αυτοαιμοσυγκόλλησης. Η απώλεια αίματος πέραν της αιμορραγίας διαπιστώνεται επίσης με την ανάλυση του ούρου και την κοπρανολογική εξέταση για την παρουσία αίματος ή/και παρασίτων. Τέλος στα διάφορα βιολογικά υλικά πραγματοποιούνται ορολογικές και μοριακές τεχνικές για την ανίχνευση παθογόνων παραγόντων καθώς και ειδικές εξετάσεις για την ανίχνευση τοξινών.
Λεπτομέρειες άρθρου
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KATSOGIANNOU, E. G., ATHANASIOU, L. V., CHRISTODOULOPOULOS, G., & POLIZOPOULOU, Z. S. (2018). Διαγνωστική προσέγγιση της αναιμίας στα μηρυκαστικά. Περιοδικό της Ελληνικής Κτηνιατρικής Εταιρείας, 69(3), 1033–1046. https://doi.org/10.12681/jhvms.18866
- Τεύχος
- Τόμ. 69 Αρ. 3 (2018)
- Ενότητα
- Review Articles
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