Steroid-responsive meningitis-arteritis: What have we learned since 2010? A narrative review

Wohlsein, Jan C.; Tipold, Andrea

doi:10.1016/j.tvjl.2023.106030

Cited by 3 publications

(1 citation statement)

References 62 publications

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“…Upon the manifestation of overt neurological signs, the definitive diagnosis of SMRA was established by considering the patient's clinical symptoms, the evolution of symptoms over time, common dog breed, cerebrospinal fluid analysis encompassing cytology and CRP, and the conclusive identification of severe intramedullary bleeding through MRI. 18,22,23 Notably, no other instances of bleeding were observed at that point, and the coagulation profile appeared unremarkable. It's important to note that a TEG was not conducted on this occasion due to the limitation that our laboratory does not offer this technique outside regular operating hours.…”

Section: Credit Authorship Contributionmentioning

confidence: 92%

Presumptive Spontaneous Hemothorax Associated to Thymic Involution in a Dog with Steroid Responsive Meningitis-Arteritis (SRMA)

Alcocer,

Bou,

Bosch

et al. 2023

Preprint

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Section: Credit Authorship Contributionmentioning

confidence: 92%

Presumptive Spontaneous Hemothorax Associated to Thymic Involution in a Dog with Steroid Responsive Meningitis-Arteritis (SRMA)

Alcocer,

Bou,

Bosch

et al. 2023

Preprint

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Prospective randomized trial comparing relapse rates in dogs with steroid‐responsive meningitis‐arteritis treated with a 6‐week or 6‐month prednisolone protocol

Rose,

Driver,

Arrol

et al. 2024

Veterinary Internal Medicne

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BackgroundTraditionally, 6‐month courses of prednisolone are used to treat steroid‐responsive meningitis‐arteritis (SRMA), but this medication is associated with adverse effects that can lead to poor quality of life.Hypothesis/ObjectivesResolution of clinical signs and rate of relapse of SRMA would not be significantly different between a 6‐month prednisolone protocol and a 6‐week protocol.AnimalsForty‐four hospital cases from multiple referral centers in the United Kingdom (2015‐2019). Twenty of 44 were treated with the 6‐month protocol and 24/44 with the 6‐week protocol.MethodsProspective, randomized trial with 12‐month follow‐up. The same prednisolone protocol reinitiated in the event of relapse. Analysis of relapses with binary logistic and Poisson regression modeling.ResultsAll cases responded to their treatment protocol. Relapses occurred in 6/20 (30%) of the 6‐month protocol and 9/24 (38%) of the 6‐week protocol. There was no statistical difference in the incidence risk of at least 1 relapse between the 2 groups (odds ratio = 1.40; 95% confidence interval [CI], 0.40‐4.96, P = 0.60). Among the 15 dogs that relapsed, 10/15 (67%) relapsed once, 3/15 (20%) relapsed twice, and 2/15 (13%) relapsed 3 times. No statistical difference was detected in the incidence rate ratio (IRR) of total relapse events between the 2 groups (IRR = 1.46; 95% CI, 0.61‐3.48; P = 0.40).Conclusions and Clinical Importance“Short” 6‐week prednisolone protocols could be used to treat SRMA, thereby presumably reducing the duration and severity of prednisolone's adverse effects.

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Idiopathic Polymyositis Showing Nonspecific Clinical Signs that Mimicked Masticatory Myositis in a Dog

Jung,

Park,

Hong

et al. 2024

J Vet Clin

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Idiopathic polymyositis and masticatory myositis are autoimmune inflammatory myopathies seen in dogs. Here we report a case involving an 11-year-old spayed female mixed-breed dog with suspected masticatory myositis that was later confirmed to be idiopathic polymyositis. The dog presented with lethargy and reluctance to walk. Blood examination indicated markedly elevated creatine kinase and C-reactive protein levels. The owners were reluctant to proceed with advanced tests; however, the dog developed new clinical signs, including trismus. T2-weighted magnetic resonance imaging revealed hyperintensities in multiple muscle groups, with the most pronounced changes occurring in the masticatory muscles. During the waiting period for the results of serology for circulating autoantibodies against type 2M myofibers, oclacitinib was administered and slightly restored vitality and appetite. The antibody test result was negative, and histopathological examination of the temporalis muscle revealed severe inflammatory myopathy with fibroplasia. Although masticatory myositis was initially suspected on the basis of the MRI findings and the presence of trismus, the final diagnosis based on the overall clinical course and diagnostic test results was idiopathic polymyositis. Immunosuppressive treatment with prednisolone and mycophenolate mofetil substantially improved the clinical condition. The findings from this case suggest that, even in cases of idiopathic polymyositis exhibiting only nonspecific clinical signs, accurate diagnosis and timely treatment are essential to achieve satisfactory clinical outcomes.

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Steroid-responsive meningitis-arteritis: What have we learned since 2010? A narrative review

Cited by 3 publications

References 62 publications

Presumptive Spontaneous Hemothorax Associated to Thymic Involution in a Dog with Steroid Responsive Meningitis-Arteritis (SRMA)

Presumptive Spontaneous Hemothorax Associated to Thymic Involution in a Dog with Steroid Responsive Meningitis-Arteritis (SRMA)

Prospective randomized trial comparing relapse rates in dogs with steroid‐responsive meningitis‐arteritis treated with a 6‐week or 6‐month prednisolone protocol

Idiopathic Polymyositis Showing Nonspecific Clinical Signs that Mimicked Masticatory Myositis in a Dog

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