Characteristics of magnetic resonance images of granulomatous meningoencephalomyelitis in 11 dogs

Cherubini, Giunio Bruto; Platt, Simon R.; Anderson, Thomas; Rusbridge, Clare; Lorenzo, Valentina; Mantis, Panagiotis; Cappello, Rodolfo

doi:10.1136/vr.159.4.110

Cited by 91 publications

(124 citation statements)

References 22 publications

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“…2 The presence of an apparently inflammatory CNS environment in the absence of CSF changes is recognized in the veterinary literature, but the reason for normal CSF remains elusive. [32][33][34] These circumstances make diagnosis challenging and so the availability of other markers of inflammation are of value in these unusual circumstances.…”

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confidence: 99%

Steroid Responsive Meningitis‐Arteritis: A Prospective Study of Potential Disease Markers, Prednisolone Treatment, and Long‐Term Outcome in 20 Dogs (2006–2008)

Lowrie

Penderis

McLaughlin

et al. 2009

Veterinary Internal Medicne

136

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Background: Previous multidrug studies have identified the value of prednisolone in treating steroid responsive meningitisarteritis (SRMA) and the potential value of acute phase proteins (APPs) and immunoglobulin A (IgA) in diagnosis and monitoring.Hypothesis: (1) Prednisolone monotherapy is a successful immunosuppressive modality in the treatment of SRMA; (2) protein markers are useful in identifying the potential for relapse.Animals: Twenty client-owned dogs with SRMA presented to the University of Glasgow Small Animal Hospital between May 2006 and May 2008.Methods: A prospective, observational study: CBC, biochemistry, and cerebrospinal fluid (CSF) analyses were performed. C-reactive protein (CRP), serum amyloid-A, a-1-acid glycoprotein, and haptoglobin (Hp) were assessed in the serum. IgA concentrations were determined in the serum and CSF.Results: Clinical resolution of SRMA was achieved in all 20 dogs. Serum CRP concentration remained increased at remission in 16/20 dogs whereas CSF cytology was within normal limits in 20/20 dogs. Serum APPs decreased significantly on treatment (P o .05) except Hp, which remained unaltered. Serum and CSF IgA concentrations remained increased for the duration of treatment.Conclusions and Clinical Importance: The prednisolone regimen presented was successful in treating SRMA without the need for additional drugs. Serum APPs are of use in the diagnosis and management of SRMA, particularly in relation to identifying relapse. Serum and CSF IgA concentrations remain increased throughout disease, aiding in diagnosis but not contributing to the management of SRMA.

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confidence: 99%

Steroid Responsive Meningitis‐Arteritis: A Prospective Study of Potential Disease Markers, Prednisolone Treatment, and Long‐Term Outcome in 20 Dogs (2006–2008)

Lowrie

Penderis

McLaughlin

et al. 2009

Veterinary Internal Medicne

136

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“…2). Meningeal enhancement is uncommon (Cherubini et al, 2006). The focal form may be indentified on magnetic resonance imaging or computed-tomography as a non-specific single space-occupying mass lesion (Speciale et al, 1992).…”

Section: Diagnosismentioning

confidence: 99%

An update on meningoencephalomyelitis of unknown aetiology in dogs

Charalambous

Δανουρδησ)²,

Hatzis³

et al. 2017

J Hellenic Vet Med Soc

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Inflammatory diseases of the central nervous system are common causes of neurological dysfunction in the dog and can be grouped into two broad categories; those of infectious and those of unknown aetiology. Μeningoencephalomyelitis of unknown aetiology include non-infectious inflammatory central nervous system diseases in which abnormal findings on magnetic resonance imaging and cerebrospinal fluid analysis indicate inflammatory central nervous system disease, but for which histopathological confirmation has not been reached. Meningoencephalomyelitis of unknown aetiology describes a group of non-infectious inflammatory diseases of the central nervous system. These include the granulomatous meningoencephalomyelitis and the necrotising encephalitis, the latter can be further distinguished into two subtypes: necrotising meningoencephalitis and necrotising leucoencephalitis. Steroid-responsive meningitis-arteritis may be also included to this category and, usually, does not present signs of encephalitis or/and myelitis (except in the chronic form) and is easier diagnosed even without histopathological examination. In most cases of meningoencephalomyelitis of unknown aetiology, a presumptive diagnosis can be achieved by the assessment of case presentation, theneurologic signs, cerebrospinal fluid testing, cross-sectional imaging of the central nervous system and appropriate microbiological tests.Definite diagnosis is achieved with histopathological examination. The underlying cause for these diseases is unknown. The clinical signs in meningoencephalomyelitis of unknown aetiology is variable and depends on which area of the central nervous sytem is affected. Meningoencephalomyelitis is acute in onset, progressive in nature and associated with multifocal to diffuse neuroanatomic localization. Extraneural signs are less common and these usually include pyrexia and peripheral neutrophilia. The differential diagnosis for dogs presented for an acute onset of multifocal central nervous system signs includes genetic abnormalities, metabolic disorders, infectious meningoencephalitis, toxin exposure, stroke and neoplasia.The diagnostic approach includes a complete blood count, a comprehensive chemistry panel, urinalysis, survey radiographs of the thorax plus abdominal ultrasound to rule out systematic disease and metastatic neoplasia, computed-tomography or magnetic reso meningitisnance imaging, cerebrospinal fluid analysis and microbiological tests.When neoplasia is suspected, computed-tomography-guided brain biopsy may be required for the differentiation. Meningoencephalomyelitis of unknown aetiology responds more or less to immunosuppressive therapies, but the prognosis should be guarded to poor with the exception of steroid-responsive meningitisarteritis, for which it is good. Treatment protocols are based on prednisolone, but new immunosuppressive agents have now been added in those to control the diseases and they seem to be effective. However, gold standard protocols have yet to be established.

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“…Several investigators have reported the MRI findings of GME as including isointensity to slight hypointensity on T1W images and hyperintensity on T2W images [3,18]. Only in some cases was enhancement detected on contrastenhanced T1W images [3].…”

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confidence: 99%

“…Only in some cases was enhancement detected on contrastenhanced T1W images [3]. With regard to the focal form of GME, some studies have reported MRI findings of isointensities on T1W, T2W, and contrast-enhanced images [10,12].…”

mentioning

confidence: 99%

Ocular Granulomatous Meningoencephalomyelitis in a Dog: Magnetic Resonance Images and Clinical Findings

Kitagawa

Okada

Watari

et al. 2009

The Journal of Veterinary Medical Science

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ABSTRACT. A 4-year-old female miniature dachshund presented with a history of progressive decrease in vision, neck pain, and ataxia for which an MRI was performed 21 days after the initial consultation. The optic nerves showed isointensities on T1-(T1W) and T2-weighted (T2W) images that were enhanced by the contrast medium. The optic chiasm was swollen. Other parts of the cerebral parenchyma, not only the visual pathway, showed symmetrical hyperintensities on T2W images. Cerebrospinal fluid showed increased anti-GFAP autoantibodies. The dog received corticosteroid therapy despite which she exhibited anorexia, vomiting, and lethargy. Hence, a follow-up MRI was repeated 30 days after the initial consultation in which T2W images showed enlargement of the hyperintense area. The dog died 45 days after the initial consultation. Postmortem pathological examination confirmed a diagnosis of granulomatous meningoencephalomyelitis (GME). KEY WORDS: canine, MRI, ocular GME.J. Vet. Med. Sci. 71(2): 233-237, 2009 Granulomatous meningoencephalomyelitis (GME) is an idiopathic inflammatory disorder of the central nervous system. Depending on the mode of onset, it is classified into 3 forms: focal, disseminated, and ocular [9]. GME mainly develops in the cerebrum, brain stem, cerebellum, and spinal cord, although it can also develop in the eyes [9]. The definitive diagnosis of GME is made by histopathological examination although several studies have revealed that imaging procedures such as magnetic resonance imaging (MRI) and computed tomography (CT), and cerebrospinal fluid (CSF) antibody tests assist in the clinical diagnosis [12,13,21].Many studies have reported the MRI findings of focal and disseminated forms of GME with few studies presenting those of the ocular form. We report the clinical signs and MRI findings of ocular form GME that was pathologically diagnosed in a dog.A 4-year-old female miniature dachshund had a 2-month history of progressive decrease in vision leading to blindness. She developed neck pain and ataxia 1 month after the onset of her symptoms. When dexamethasone administration at a local clinic did not receive in alleviation of her symptoms, the dog was brought to Nihon University Animal Medical Center. On preliminary examination, bilateral pupillary dilatation was observed without ocular signs such as discharge or conjunctival hyperemia. Ocular tension was slightly increased in both eyes (L23, R24 mmHg; reference values 19.2-5.9 [8]). Fundus examination revealed an irregular left optic disc suggestive of papilledema. Ultrasonic imaging of the eyes revealed enlargement of the optic discs.Neurological examination revealed a decreased menace reaction, pupillary dilatation, and loss of the light reflex in both eyes. An MRI was planned, but it was delayed due to the owner's circumstances, and corticosteroid therapy was continued. Since the dog exhibited circling to the left, MRI and CSF collection were performed 21 days after the initial consultation. The left and right optic nerves showed isointensities...

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Characteristics of magnetic resonance images of granulomatous meningoencephalomyelitis in 11 dogs

Cited by 91 publications

References 22 publications

Steroid Responsive Meningitis‐Arteritis: A Prospective Study of Potential Disease Markers, Prednisolone Treatment, and Long‐Term Outcome in 20 Dogs (2006–2008)

Steroid Responsive Meningitis‐Arteritis: A Prospective Study of Potential Disease Markers, Prednisolone Treatment, and Long‐Term Outcome in 20 Dogs (2006–2008)

An update on meningoencephalomyelitis of unknown aetiology in dogs

Ocular Granulomatous Meningoencephalomyelitis in a Dog: Magnetic Resonance Images and Clinical Findings

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