Paraneoplastic Syndromes

Bailey, Dennis B.

doi:10.1016/b978-0-323-59496-7.00005-0

Cited by 5 publications

(3 citation statements)

References 181 publications

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“…Hemostatic derangements in cancer patients may develop via multiple mechanisms. These include inherent abnormalities of tumor microvasculature, invasion into blood vessels and/or tissue factor expression by neoplastic cells ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: Disseminated intravascular coagulation in a dog following treatment with melarsomine for Dirofilaria immitis

Philp

Farrell²,

Li³

2023

Front. Vet. Sci.

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Disseminated intravascular coagulation following melarsomine therapy for Dirofilaria immitis (D. immitis) is reported in a 9-year-old female intact pit bull-type dog. The dog had been diagnosed with D. immitis (antigen and microfilaria positive) and treated with imidacloprid, moxidectin, doxycycline and 3 doses of melarsomine over a 92-day period. Seven days after the third melarsomine injection, the patient was presented to her family veterinarian due to right pelvic limb swelling. Prothrombin and activated partial thromboplastin times were prolonged beyond the detectable range. Treatment included vitamin K1 and fresh frozen plasma (FFP) prior to referral to the authors' institution. At this time the patient remained coagulopathic. Further investigations included thoracic radiographs, abdominal ultrasound and an echocardiogram. The patient was administered multiple units of packed red blood cells and FFP, sildenafil, dexamethasone SP, aminocaproic acid and vitamin K1. Repeat CBC approximately 20 h after admission showed persistent anemia and thrombocytopenia. Despite ongoing administration of FFP, a repeat coagulation panel showed worsening of the coagulopathy with prothrombin time of 84.2s [reference interval (RI) 7.0–9.3s], activated partial thromboplastin time >140s (RI 10.4–12.9s) and fibrinogen <50 mg/dL (RI 109–311 mg/dL). Following discussion with the owners, the patient was euthanized. Necropsy was performed and confirmed heartworm infection with severe pulmonary arterial thrombosis, vascular remodeling, and intraluminal degenerate nematodes. Multifocal subcutaneous and organ hemorrhage was apparent. Although coagulopathy has been described in caval syndrome associated with heartworm disease and is listed as a potential side effect of melarsomine administration, this is the first report of documented disseminated intravascular coagulation following melarsomine treatment for D. immitis. Potential mechanisms for the coagulopathy are discussed and the case report highlights a rare, but serious complication of adulticide therapy.

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Section: Discussionmentioning

confidence: 99%

Case report: Disseminated intravascular coagulation in a dog following treatment with melarsomine for Dirofilaria immitis

Philp

Farrell²,

Li³

2023

Front. Vet. Sci.

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“…Paraneoplastic syndromes encompass a wide range of neoplasia-related structural and functional changes in the body, mediated by various small molecules secreted by the primary tumour or its metastases. 1 Paraneoplastic syndromes can manifest in a variety of ways, including hypercalcaemia, erythrocytosis, hypoglycaemia and leukocytosis. 2 Granulocyte-colony stimulating factor (G-CSF) is a myelopoietic cytokine, which along with others (such as granulocyte-macrophage colony-stimulating factor [GM-CSF], IL-1, IL-3, IL-6 and TNF-α) has previously been reported to be significantly upregulated in leukaemoid paraneoplastic syndromes in a number of cancers in people, including sarcomas, carcinomas, mesotheliomas and melanomas.…”

Section: Introductionmentioning

confidence: 99%

“…Paraneoplastic syndromes encompass a wide range of neoplasia‐related structural and functional changes in the body, mediated by various small molecules secreted by the primary tumour or its metastases 1 . Paraneoplastic syndromes can manifest in a variety of ways, including hypercalcaemia, erythrocytosis, hypoglycaemia and leukocytosis 2 .…”

Section: Introductionmentioning

confidence: 99%

Paraneoplastic leukocytosis in a dog following liposarcoma resection

Cutler,

Blackwood,

Pratschke

et al. 2024

Vet Record Case Reports

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A 10‐year‐old, female, neutered cocker spaniel presented for surgical debulking of an axillary and cranial thoracic wall liposarcoma. Pre‐surgical blood analysis demonstrated anaemia (packed cell volume 17%), leukocytosis (white blood cell count 43.95 × 109/L) and thrombocytopenia (15 × 109/L), with platelet loss secondary to chronic intra‐lesional haemorrhage or immune‐mediated destruction, and concomitant Staphylococcus pseudintermedius urinary tract infection. A blood transfusion and antibiotics were administered before surgery. Within 48 hours after surgery, an extreme leukocytosis (white blood cell count 170 × 109/L), involving a severe left shift neutrophilia (95 × 109/L) was observed; this resolved within 10 days. Serum granulocyte‐colony stimulating factor levels were similar to controls. The extreme leukocytosis was suspected to be related to a paraneoplastic leukaemoid reaction combined with an expected postoperative mild leukocytosis. Further investigation into the pathophysiology underlying similar cases is required. One month after surgery, all haematological abnormalities had normalised, and metronomic chemotherapy with chlorambucil commenced.

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Hemostatic Dysfunction in a Dog with Mammary Gland Carcinoma

et al. 2022

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Hypercoagulability is the most common coagulopathy seen in dogs with neoplasia, whereas a hypocoagulable state is relatively rare. A 16-year-old spayed female miniature Schnauzer presented with bilateral epistaxis, bilateral hindlimb swelling, and lameness. Previously, the dog was diagnosed with intermediate grade solid carcinoma after mastectomy, and then showed generalized ecchymoses on the abdomen and bilateral hindlimbs on presentation. Laboratory tests revealed a hypocoagulable state, including thrombocytopenia, hypofibrinogenemia, and delayed prothrombin and activated partial thromboplastin time. Thromboelastography demonstrated a prolonged K time with a decreased alpha angle and low maximal amplitude, reflecting a decrease in clot strength. The hypocoagulable state of disseminated intravascular coagulopathy was speculated based on the presence of an underlying tumor, clinical symptoms, and laboratory results of the hypocoagulable state. This case shows the incidence of hemostatic dysfunction as a paraneoplastic syndrome in a dog with mammary gland carcinoma.

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Paraneoplastic Syndromes

Cited by 5 publications

References 181 publications

Case report: Disseminated intravascular coagulation in a dog following treatment with melarsomine for Dirofilaria immitis

Case report: Disseminated intravascular coagulation in a dog following treatment with melarsomine for Dirofilaria immitis

Paraneoplastic leukocytosis in a dog following liposarcoma resection

Hemostatic Dysfunction in a Dog with Mammary Gland Carcinoma

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