Serum concentrations of immunoglobulin G (IgG), IgM, and IgA were measured in 9 Cavalier King Charles Spaniels with pneumonia caused by Pneumocystis sp that were examined at 4 veterinary surgeries in the United Kingdom (UK) between September 2001 and November 2002. Pneumocystis pneumonia was confirmed in all dogs by visualization of the organism in bronchoalveolar lavage fluid or a transthoracic lung aspirate. Two dogs had a history of demodicosis. Immunoglobulin concentrations also were measured in breed-and age-matched dogs sampled over the same period. IgG concentrations were significantly (P = .000) lower in the affected dogs (median 3.2 mg/mL) than in the control dogs (median 8.5 mg/mL). IgM concentrations were significantly (P = .002) higher in the affected dogs (median 1.95 mg/mL) than in the control dogs (median 1.12 mg/mL). One affected dog had no change in IgG concentration more than 3 months after resolution of infection or vaccination, but did have reduction in IgM concentration after resolution of infection and vaccination. Control dogs had low serum IgG and IgM concentrations, compared with the reference interval for all dogs. Lymphocyte count in blood was normal or high in 7 of 8 affected dogs. The results of this study suggest that there is a defect in immunity in Cavalier King Charles Spaniels that underlies the susceptibility of these dogs to pneumocystosis. Further studies are indicated to elucidate the mechanisms behind the defect, the prevalence within the breed, and the potential mode of inheritance of the problem.
SUMMARY The frequency, severity, and characteristics of psychiatric illness and stressful life situations were assessed in 134 patients aged 18-60 years referred to a gastrointestinal clinic by their general practitioner. A functional disorder of the gastrointestinal tract was established in 72%. A formal psychiatric assessment in 64 randomly selected patients revealed a previous or current psychiatric disorder in 54% of the functional group and 12.5% of the organic group. Stressful life events before referral were assessed by a modification of the Bedford College methodology. Anxiety provoking life situations were found in 30%, a proportion which was not significantly different in the two groups. Psychiatric illness episodes and/or anxiety provoking situations, preceded the onset of bowel symptoms in two-thirds of the functional group, however, but in none of the organic group. Life situations alone did not appear to be associated with functional disorders unless they provoked an anxiety state.Functional disorders of the gastrointestinal tract are the most common of all gastrointestinal disorders and account for 50% of referrals to a gastrointestinal clinic. ' The majority of such patients have an irritable bowel syndrome characterised by abdominal pain associated with a change in bowel habit in the absence of demonstrable organic disease. In a randomly selected normal population, one-third regularly experienced similar gastrointestinal symptoms two-thirds of whom admitted to abdominal pain associated with a change in bowel habit.2 Despite the frequency of gastrointestinal symptoms in an apparently healthy population, less than a quarter consult their general practitioner because of these symptoms.2 If these symptoms are widely prevalent yet do not precipitate requests for consultation, the implication is that patients seeking advice do so either because the severity of symptoms is greater or there is a reduced tolerance due to other factors -for example, psychiatric illness or psychosocial distress.34This study was undertaken to assess the frequency, severity and characteristics of psychiatric illness and stressful life situations in patients referred to a
Serum concentrations of immunoglobulin G (IgG), IgM, and IgA were measured in 9 Cavalier King Charles Spaniels with pneumonia caused by Pneumocystis sp that were examined at 4 veterinary surgeries in the United Kingdom (UK) between September 2001 and November 2002. Pneumocystis pneumonia was confirmed in all dogs by visualization of the organism in bronchoalveolar lavage fluid or a transthoracic lung aspirate. Two dogs had a history of demodicosis. Immunoglobulin concentrations also were measured in breed-and age-matched dogs sampled over the same period. IgG concentrations were significantly (P = .000) lower in the affected dogs (median 3.2 mg/mL) than in the control dogs (median 8.5 mg/mL). IgM concentrations were significantly (P = .002) higher in the affected dogs (median 1.95 mg/mL) than in the control dogs (median 1.12 mg/mL). One affected dog had no change in IgG concentration more than 3 months after resolution of infection or vaccination, but did have reduction in IgM concentration after resolution of infection and vaccination. Control dogs had low serum IgG and IgM concentrations, compared with the reference interval for all dogs. Lymphocyte count in blood was normal or high in 7 of 8 affected dogs. The results of this study suggest that there is a defect in immunity in Cavalier King Charles Spaniels that underlies the susceptibility of these dogs to pneumocystosis. Further studies are indicated to elucidate the mechanisms behind the defect, the prevalence within the breed, and the potential mode of inheritance of the problem.
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