Resumo:A hepatozoonose canina é uma enfermidade causada pelo protozoário Hepatozoon sp., recentemente descoberta no Brasil, com poucos casos descritos. Ela é transmitida principalmente através da ingestão do carrapato Rhipicephalus sanguineus com oocistos esporulados de H. canis. A patogenicidade e sintomatologia são bastante variáveis, dependendo da idade do animal, do grau de infecção e da associação com outras doenças. A sintomatologia pode se apresentar de forma assintomática a letal. O diagnóstico da hepatozoonose baseia-se em esfregaço sanguíneo, biopsia, sorologia e PCR. O objetivo do trabalho é descrever as alterações clínicas e laboratoriais em dois cães com hepatozoonose atendidos em Fortaleza, Ceará. O primeiro caso, macho, com 3 meses de idade, apresentou agressividade, andar em círculos, atonia nos membros posteriores, anorexia, convulsão, mucosas hipocoradas e secreção ocular. O segundo caso, cadela, com 1 ano de idade, apresentou anorexia. Ao exame físico, observou-se a presença de carrapatos, mucosas hipocoradas e temperatura de 38,6°C. Amostras de sangue foram coletadas para realização de hemograma, dosagens bioquímicas e pesquisa de hematozoários. O diagnóstico caracterizouse pela visualização de gametócitos de Hepatozoon sp em neutrófilos em esfregaço sanguíneo. Anemia regenerativa, discreta neutrofilia, linfócitos reativos e monócitos vacuolizados foram observados. Um animal apresentou trombocitopenia. Hiperbilirrubinemia, hipoalbuminemia estiverem presentes. Os níveis de ALT apresentaram-se dentro dos limites normais, entretanto, AST, CPK, uréia e creatinina encontraram-se alterados. Um animal veio a óbito. Conclui-se que a hepatozoonose é uma enfermidade presente em Fortaleza, Ceará. Ela induz alterações clínicas, hematológicas e bioquímicas que podem ser fatais para o animal.Palavras-chave: Alterações laboratoriais, cão, Fortaleza, hepatozoonose. Clinical and laboratory findings in canine hepatozoonosis in Ceará: report of two casesAbstract: Canine hepatozoonosis is a disease caused by protozoan Hepatozoon sp., recently discovered in Brazil, with few cases. It is transmitted mainly through ingestion of Rhipicephalus sanguineus with oocysts of H. canis. Pathogenicity and symptoms are variable depending on the age of the animal, the degree of infection and the association with other diseases. The symptoms can present in lethal asymptomatic. The diagnosis of hepatozoonosis is based on blood smears, biopsy, serology and PCR. The objective is to describe the clinical and laboratory findings in two dogs with hepatozoonosis met in Fortaleza, Ceará. The first case, male, 3 months old, showed aggression, circling, lethargy hind limbs, anorexia, seizures,
Background: Canine Leishmaniasis (CanL) is a multisystemic and chronic inflammatory disease characterized by nonspecific clinical manifestations. In CanL, inflammatory cells and chemical mediators released in response to the parasite play a role in disease development and progression. Alterations on hematological parameters have been documented in CanL. These changes can also be assessed in relation to systemic inflammation caused by this disease. The circulating leukocyte counting, such as neutrophils, as well as the albumin level, are considered direct indicators of an inflammatory host environment. Several studies point to the use of biomarkers on the assistance in diagnosis and prognosis of several canine pathologies. The present study investigated the Neutrophils to Lymphocyte Ratio (NLR), Albumin to Globulin Ratio (AGR), and Neutrophils to Albumin Ratio (NAR) on systemic inflammatory response induced by Canine Leishmaniasis (CanL).Materials, Methods & Results: For this purpose, adult dogs with confirmed diagnosis to CanL were divided into symptomatic (SD, n = 33) and asymptomatic (AD, n = 20) dogs for L. infantum and control dogs (CD, n = 20). Routine hematological and biochemical parameters were determined in blood samples using a veterinary automatic hematology and biochemical analyzers. Asymptomatic dogs (AD) had a higher number of white blood cells and neutrophils (16.48 ± 4.93; 13.41 ± 3.60, respectively) in relation to symptomatic dogs (SD) (13.54 ± 5.13; 10.42± 3.69, respectively) (P = 0.015 and P < 0.0001, respectively). Neutrophils to Lymphocyte Ratio (NLR) was higher in dogs with leishmaniasis (9.45 ± 3.76) than in healthy dogs (3.39 ± 1.19) (P < 0.0001). Serum total proteins (STP) and globulins increased in CanL, while albumin and AGR decreased in CanL, when compared to CD and references values to canine species. Neutrophils to Albumin Ratio (NAR) was higher in AD and SD (5.02 ± 1.14; 4.79 ± 1.07, respectively) when compared to CD (2.36 ± 0.55) (P < 0.0001). Discussion: As reported in scientific researches, dogs with Leishmaniasis present alterations in circulating cell counts. Based on these data, we decided to expand this information using the NLR as a parameter in an attempt to better clarify the changes in these cells in CanL. We observed that NLR was increased on CanL in relation to healthy dogs, which could be a consequence of relative neutrophilia rather than lymphopenia. Neutrophils to Lymphocyte Ratio (NLR) is a biomarker that conveys information about inflammatory conditions. An elevated NLR can reflect an upregulated innate immune response, since neutrophils are effector cells of innate immunity and are involved in several acute and chronic inflammatory processes. Albumin is an acute phase protein that is considered an immune-inflammatory biomarker, which can be found reduced systemically in progressive inflammatory response. Serum total proteins (STP) and globulins were increased in CanL. These data are already well documented in CanL, which serum globulins are mainly associated with the increase of acute phase proteins, cytokines, and increase of specific antibodies to Leishmaniainfantum. Our results showed neutrophilia with hypoalbuminemia in CanL. So, in an attempt to assess the relationship of these two available markers, we used NAR calculation in order to evaluate the changes induced by CanL. In this study NAR was higher in CanL when compared to control dogs. Thus, our data indicate that NLR and NAR could be used as biomarkers in veterinary medical clinics in order to assess inflammatory profile in CanL, mainly in asymptomatic dogs. These parameters obtained from routine blood tests might be useful as cost-effective, easily accessible and helpful markers in order to distinguish the inflammatory response intensity in CanL.
O objetivo desta revisão é esclarecer o triplo papel, reservatório-vítima-sentinela, que o cão exerce na leishmaniose visceral e discutir o foco na eliminação do “melhor amigo do homem” para proteção do ecossistema, levando-se em conta os três pilares epidemiológicos, parasito-vetor-hospedeiro, e os aspectos éticos. Logo, inicialmente serão abordados aspectos epidemiológicos relacionados a Leishmaniose Visceral (LV) e a Leishmania Visceral Canina (LVC). Posteriormente, uma reflexão sobre o papel do cão neste contexto, tido como principal reservatório da Leishmania infantum no ambiente urbano, será realizada visando a compreensão de medidas como a eutanásia, de animais positivos; a manutenção do cão parasitado na família (vítima) e o uso destes animais como sentinelas para a detecção da LV e LVC. Finalmente, conclui-se que a LVC é um problema que aflige a família multiespécie brasileira, afetando seres humanos e cães. Os métodos de controle e vigilância paras a LV implementadas no Brasil ainda são ineficientes e desatualizados, desconsiderando o cão como membro da família e tratando-o unicamente como hospedeiro reservatório. Portanto é fundamental uma revisão no Programa de Controle e Vigilância que inclua a Saúde Única na forma de lidar com as leishmanioses: hospedeiros, vetores e parasitos, dentro de um mesmo ambiente para dirigir recursos em medidas eficientes, com o cão sendo utilizado como sentinela da LV.
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