Splenic Nodules: Canine Visceral leishmaniasis?
DOI:
https://doi.org/10.22456/1679-9216.108488Abstract
Background: Canine visceral leishmaniasis (CVL) is a parasitic disease of high lethality caused by the protozoan Leishmania infantum in Brazil and is often related to splenomegaly. However, splenic nodules in dogs, although frequent, have not previously been reported as associated with CVL, but with neoplastic diseases. Considering that most dogs infected are oligosymptomatic or asymptomatic and that splenic nodules are common to other diseases, it is prudent to differentially diagnose CVL in view of its high zoonotic potential and lethality. The objective of the study was to describe a case of splenomegaly with splenic nodules associated with CVL in an asymptomatic dog treated with 2% miltefosina.
Case: A 5-year-old male Rottweiler with 41 kg, with a history of inappetence, apathy and weight loss was referred to the Veterinary Medicine School Clinic of the Cesmac University Center, Maceió, AL, Brazil. However, during palpation a slight increase in the spleen was noted. Hematological, hemoparasite, biochemical and abdominal ultrasonographic examinations were requested to clarify the clinical suspicion of hemoparasitosis. The hematological and biochemical results respectively showed the following: normocytic normochromic anemia, hyperproteinemia and thrombocytopenia, in addition to hypoalbuminemia, with elevated total protein levels. The test for hemoparasites was negative. Ultrasonography showed mixed echogenicity suggestive of nodules. The rapid test for Ehrlichia, Anaplasma and L. infantum was performed. It was positive only for L. infantum. ELISA, IFAT and qPCR tests were performed to confirm the result. The test showed a cut-off result of 0.371 for ELISA, positive for RIFI at a cut-off of 1:40 and qPCR with less than 1 fg and with amplification above 36 cycles. In view of these results, treatment with 2% miltefosine at a dose of 1 mL/ 10 kg was started once a day, after feeding, for 28 days. The animal was monitored throughout treatment and re-evaluated every 10 days for 30 days, showing signs of clinical development, presenting satisfactory results.
Discussion: Canine splenomegaly can be associated with a variety of disease possibilities. In asymptomatic canine visceral leishmaniasis (CanL), the slight increase in spleen and the presence of splenic nodules may lead to a false diagnosis. Splenic nodules may be associated with dogs of advanced age and may be due to lymphoid nodular hyperplasia, which causes nodules with echogenicity, hyperechoic regions with well demarcated irregularity, with centralized hypoechoic areas and an absence of hematological and biochemical alterations. The cause of splenomegaly associated with nodules may be difficult to diagnose and require much time and effort. Therefore, diseases such as visceral leishmaniasis of high lethality must be the priority in differential diagnosis in endemic areas in order to minimize the risk of transmission. In addition to allowing an early intervention aiming at good animal health results and preventive measures, such as the use of repellent collars that reduce the risk of phlebotomo infection. The differential diagnosis of CVL is necessary in endemic areas, even in asymptomatic dogs that may present splenic alterations suggestive of other diseases. Treatment with 2% miltefosine was shown to be, in this case, effective at reducing the splenic nodules and a good alternative for the quality of life of the animal.
Downloads
References
Akhoundi M., Kuhls K., Cannet A., Votýpka J., Marty P., Delaunay P. & Sereno D. 2016. A Historical Overview of the Classification, Evolution, and Dispersion of Leishmania Parasites and Sandflies. PLOS Neglected Tropical Diseases. 10(3): e0004349. DOI: https://doi.org/10.1371/journal.pntd.0004349.
Alanzi A.D., Puschendorf R., Alyousif M.S., Al-Khalifa M.S., Alharbi S.A., Al-Shehri Z.S., Said A.E., Alanazi I.O., Al-Mohammed H.I. & Alraey Y.A. 2019. Molecular Detection of Leishmania spp. in Skin and Blood of Stray Dogs from Endemic Areas of Cutaneous Leishmaniasis in Saudi Arabia. Iranian Journal of Parasitology. 14(2): 231-239. DOI: https://doi.org/10.18502/ijpa.v14i2.1135
BRASIL. Ministério da Saúde. 2006. Manual de Vigilância e Controle da Leishmaniose Visceral. Brasília: Ministério da Saúde, 120p.
Ferroglio E., Battisti E., Zanet S., Bolla C., Concialdi E., Trisciuoglio A., Khalili S. & Biglino A. 2018. Epidemiological evaluation of Leishmania infantum zoonotic transmission risk in the recently established endemic area of Northwestern Italy. Zoonoses Public Health. 65(6): 675-682. DOI: 10.1111/zph.12477.
Franco-Zetina M., Adame-Gallegos J. & Dzul-Rosado K. 2019. Efectividad de los métodos diagnósticos para la detección de ehrlichiosis monocítica humana y canina. Revista Chilena Infectologia. 36(5): 650-655. DOI: http://dx.doi.org/10.4067/S0716-10182019000500650.
Freire S.M., Campos A.P., Cavalcante R.R., Lindoso J.A.L. & Costa F.A.L. 2014. Dinâmica das alterações do baço associadas ao estado clínico de cães com leishmaniose visceral. Revista Brasileira de Ciência Veterinária. 21(1): 27-32.
Martins N.S., Coelho G.B., Santos L.S., Oliveira R.A., Silva A.L.A. & Melo F.A. 2015. Alterações da matriz extracelular esplênica em cães naturalmente infectados com Leishmania (Leishmania) infantum chagasi. Ciência Animal Brasileira. 16(1): 103-115. DOI: https://doi.org/10.1590/1089-68916i123500.
Mangano C., Macrì F., Di Pietro S., Pugliese M., Santoro S., Iannelli N.M., Mazzullo G., Crupi R. & De Majo M. 2019. Use of contrast-enhanced ultrasound for assessment of nodular lymphoid hyperplasia (NLH) in canine spleen. BMC Veterinary Research. 15(196): 1-9. DOI: 10.1186/s12917-019-1942-5.
Nogueira F.S., Avino V.C., Galvis-Ovallos F., Pereira-Chioccola V.L., Moreira M. A.B., Romariz A.P.P.L., Molla L.M. & Menz I. 2019. Use of miltefosine to treat canine visceral leishmaniasis caused by Leishmania infantum in Brazil. Parasites and Vectors. 8(12): 79. DOI: DOI: 10.1186/s13071-019-3323-0
Oliveira B.F.S. 2019. Existe concordância entre o nested pcr e o 4dx® plus no diagnóstico de erliquiose canina? 45f. Alegre, ES. Dissertação (Mestrado em Ciências Veterinárias) - Programa de Pós-Graduação em Ciências Veterinárias, Universidade Federal do Espírito Santo.
Paiva-Cavalcanti M., Brito M.E.F., Souza W.V., Gomes Y.M. & Abath F.G.C. 2009. The development of a real-time PCR assay for the quantification of Leishmania infantum in canine blood. The Veterinary Journal. 182(2): 356-358. DOI: 10.1016/j.tvjl.2008.05.018.
Ribeiro C.R., Goncalves C.A., Cruz L.M. & Galera P.D. 2019. Prevalence of visceral canine leishmaniosis and coinfections in periurban region in the federal district - Brazil. Ciência Animal Brasileira. 20(1-8): 1-8. DOI: http://dx.doi.org/10.1590/1089-6891v20e-49589.
Rosário C.J.R.M., Dominici M.F., Braga M.S.C.O., Lima C.A.A., Pereira J.G. & Melo F.A. 2018. Quantificação da IL-10 e do INF-γ em cães com ou sem sinais clínicos de infecção com Leishmania (Leishmania) chagasi. Pesquisa Veterinária Brasileira. 38(1): 129-132. DOI: https://doi.org/10.1590/1678-5150-pvb-5107.
Santana C.C., Freitas L.A.R.O., Santos G.G.S. & Washington L.C. 2019. Disorganization of spleen compartments and dermatitis in canine visceral Leishmaniasis. Surgical and Experimental Pathology. 2(14): 1-8. DOI: 10.1186/s42047-019-0040-0.
Silva M.V.M., Fernandes R.A., Nogueira J.L. & Ambrósio C.E. 2011. Erliquiose canina: revisão de literatura. Arquivo Ciência Veterinária Zoologia. 14(2): 139-143.
Terreazano G., Cortese L., Piantedosi D., Zappacosta S., Di Loria A., Santoro D., Ruggiero G. & Ciaramella P. 2006. Presence of anti-platelet IgM and IgG antibodies in dogs naturally infected by Leishmania infantum. Veterinary Immunology and Immunopathology. 110(3-4): 331-337. DOI: https://doi.org/10.1016/j.vetimm.2005.11.001
Travi B.L., Cordeiro-da-Silva A., Dantas-Torres F. & Miró F.G. 2018. Canine visceral leishmaniasis: Diagnosis and management of the reservoir living among us. PLOS Neglected Tropical Diseases. 12(1): 1-13. DOI: https://doi.org/10.1371/journal.pntd.00060
Yankin I., Nemanic R., Funes S., Morais H., Gorman E. & Ruaux C. 2019. Clinical relevance of splenic nodules or heterogeneous splenic parenchyma assessed by cytologic evaluation of fine-needle samples in 125 dogs (2011-2015). Journal Veterinary Internal Medicine. 34(1): 125-131.
Published
How to Cite
Issue
Section
License
This journal provides open access to all of its content on the principle that making research freely available to the public supports a greater global exchange of knowledge. Such access is associated with increased readership and increased citation of an author's work. For more information on this approach, see the Public Knowledge Project and Directory of Open Access Journals.
We define open access journals as journals that use a funding model that does not charge readers or their institutions for access. From the BOAI definition of "open access" we take the right of users to "read, download, copy, distribute, print, search, or link to the full texts of these articles" as mandatory for a journal to be included in the directory.
La Red y Portal Iberoamericano de Revistas Científicas de Veterinaria de Libre Acceso reúne a las principales publicaciones científicas editadas en España, Portugal, Latino América y otros países del ámbito latino