Massive uric acid crystalluria and cylinduria in a dog after l-asparaginase treatment for lymphoma.


Journal

Veterinary clinical pathology
ISSN: 1939-165X
Titre abrégé: Vet Clin Pathol
Pays: United States
ID NLM: 9880575

Informations de publication

Date de publication:
Sep 2019
Historique:
received: 19 06 2018
revised: 31 07 2018
accepted: 14 08 2018
pubmed: 17 5 2019
medline: 6 2 2020
entrez: 17 5 2019
Statut: ppublish

Résumé

A 10-year-old golden retriever bitch was treated for diarrhea and vomiting that lasted about 1 month without a specific diagnosis until a hepatic biopsy provided a histopathologic diagnosis of lymphoma. The dog was referred to the Swedish University of Agricultural Science and treated with one dose of l-asparaginase. The day after chemotherapy, the urine was dark yellow, very turbid, and had large amounts of small amorphous crystals and many casts made of similar appearing material identified by infrared spectroscopy to be 100% uric acid dihydrate. Serum uric acid was elevated at 224 μmol/L (RI 0-59). The dog's illness became worse after chemotherapy. Lymphoma treatment was not continued, and the dog was euthanized 9 days after the l-asparaginase treatment. Among other problems were persistent proteinuria with a urine protein-to-creatinine ratio of 2.3 and severe hypoalbuminemia. Serum protein electrophoresis performed 3 weeks prior to chemotherapy indicated hyperproteinemia (total protein 78 g/L) having a biclonal gammopathy with 35 g/L β-2 globulins and 11 g/L γ globulins. Despite prominent cylinduria and crystalluria, the patient did not develop azotemia or isosthenuria.

Identifiants

pubmed: 31093999
doi: 10.1111/vcp.12719
doi:

Substances chimiques

Uric Acid 268B43MJ25
Asparaginase EC 3.5.1.1

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

425-428

Informations de copyright

© 2019 American Society for Veterinary Clinical Pathology.

Références

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Vickery KRm, Thamm DH. Successful treatment of acute tumor lysis syndrome in a dog with multicentric lymphoma. J Vet Intern Med 2007;21:1401-1404.
Piek CJ, Teske E. Tumor lysis syndrome in a dog. Tijdschr Diergeneeskd. 1996;121:64-66.
Anonymous. NEVPC Case 15. Northeastern Veterinary Pathology Conference 2017. https://www.askjpc.org/wsco/nec/pdf/Case15.pdf. Accessed February 5, 2018.
Oda M, Satta Y, Takenaka O, et al. Loss of urate oxidase activity in hominoids and its evolutionary implications. Mol Biol Evol. 2002;19:640-653.
Rivara CM, Johnson CR, Lulich JP, et al. The effect of disease on the urinary purine metabolite concentrations in dogs. Vet Rec. 2013;173:219-224.
Meichner K, Olsson SA, Stewart DR, et al. What is your diagnosis? Urine crystals in a dog. Vet Clin Pathol. 2015;44(4):613-614.
Tvedten HW, Reid RW. What is your diagnosis? Urinary casts of crystals. Vet Clin Path. 1997;26:181-194.

Auteurs

Harold Tvedten (H)

University Animal Hospital Swedish University of Agricultural Sciences, Uppsala, Sweden.

Inger Lilliehöök (I)

Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.

Henrik Rönnberg (H)

Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.

Lena Pelander (L)

Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.

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Classifications MeSH