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C-reactive protein concentration in dogs with primary immune-mediated hemolytic anemia
Christine Griebsch1, Gisela Arndt, Jens Raila
1Faculty of Veterinary Medicine, Clinic of Small Animals and.
Insights
C-reactive protein (CRP) levels are significantly elevated in dogs with immune-mediated hemolytic anemia (IMHA). While CRP did not predict short-term survival, it may serve as a valuable tool for long-term patient monitoring in IMHA cases.
Area of Science:
- Veterinary Medicine
- Immunology
- Canine Health
Background:
- Canine primary immune-mediated hemolytic anemia (IMHA) presents a significant mortality risk.
- C-reactive protein (CRP), a key acute-phase protein in dogs, shows potential as a prognostic indicator in IMHA.
Purpose of the Study:
- To evaluate serum CRP concentrations in dogs with primary IMHA at the time of diagnosis and throughout treatment.
- To determine if CRP levels differ based on survival outcomes.
- To compare CRP levels with other inflammatory and prognostic laboratory markers.
Main Methods:
- Inclusion criteria for primary IMHA included anemia, a positive Coombs' test or autoagglutination, and exclusion of other diseases.
- Dogs were categorized into two groups: survivors at 14 days (group 1) and non-survivors (group 2).
- Serum CRP, complete blood count (CBC), and biochemistry profiles were analyzed on days 0, 3, 8, and 14. CRP was also measured in healthy controls.
Main Results:
- Serum CRP was markedly elevated in IMHA dogs compared to healthy controls (median 224 µg/mL vs. 2.2 µg/mL on day 0).
- CRP levels decreased over time in survivors but remained elevated in non-survivors.
- No significant difference in CRP concentration was observed between the survival groups at presentation, though correlations with WBC were noted.
Conclusions:
- Serum CRP concentration is significantly increased in dogs diagnosed with primary IMHA.
- CRP levels did not differentiate between short-term survival outcomes in this study.
- CRP may hold value as a marker for long-term monitoring of canine IMHA patients.
Background:
Canine primary immune-mediated hemolytic anemia (IMHA) is associated with a high-mortality rate. C-reactive protein (CRP) is the most important acute-phase protein in dogs and may have value as a marker of prognosis or response to treatment in IMHA.
Objective:
The objectives of this study were to evaluate serum CRP concentration in dogs with primary IMHA at presentation and during treatment, to assess potential differences based on survival time, and to compare CRP with other laboratory parameters of inflammation and prognosis.
Methods:
Inclusion criteria for primary IMHA were anemia (PCV<0.30 L/L), a positive Coombs' test or persistent autoagglutination of erythrocytes, and the exclusion of underlying diseases by other diagnostic tests. Dogs were divided into 2 groups based on survival: dogs that were still alive 14 days after start of treatment (group 1) and dogs that died or were euthanized before day 14 (group 2). Serum CRP concentration, a CBC, and a biochemistry profile were performed on days 0, 3, 8, and 14. Serum CRP also was determined in 25 clinically healthy dogs.
Results:
CRP concentration in the 25 clinically healthy dogs ranged from 0-8.9 microg/mL (median 2.2 microg/mL). Thirty dogs were diagnosed with primary IMHA, 24 in group 1 and 6 in group 2. On day 0, CRP concentration in dogs in both groups (median 224 microg/mL) was increased above the reference interval. In group 1 dogs, median CRP concentration was 242 microg/mL on day 0, 69 microg/mL on day 3, 35 microg/mL on day 8, and 2 microg/mL on day 14. In group 2 dogs, median CRP concentration was 194 microg/mL on day 0, 119 microg/mL on day 3, and 41 microg/mL on day 8; only 1 dog in group 2 survived to day 8. There was a significant correlation between CRP and total WBC concentrations on days 0 and 3 (r=-.598, P=.003).
Conclusions:
Serum CRP concentration was markedly increased in dogs with primary IMHA. CRP concentration did not differ based on patient survival, but might be a marker for long-term monitoring of these patients.
