D-dimer / Fibrinogen Ratio in Dogs with Ehrlichiosis

Öz

Thromboembolism is one of the important problems affecting mortality levels in diseases with bleeding disorders. It is known that deep venous thrombosis and thromboembolism are formed in diseases such as Ehrlichiosis which may cause hemorrhagic disorder but advanced diagnostic techniques are needed for a precise diagnosis. In this study, the aim was to determine D-dimer / fibrinogen ratios by D-dimer test in monoinfected dogs with Ehrlichiosis. For this purpose, dogs presenting high fever, lymphadenopathy and anorexia to those of mono-infected with Ehrlichiosis as detected by point of care rapid ELISA test Snap 4dx along within healthy ones (n=10) as determined within clinical and laboratory evaluation. Enrolled dogs in the present study were subjected to withdrawal of a total of 5 ml EDTA and citrated blood samples from V.cephalica antebrachi in an attempt to calculate D-dimer / Fibrinogen ratio by use of D-dimer and Fibrinogen levels as detected by commercial test kits. D-dimer (3059.01074.4 ng/ml) and Fibrinogen (371.062.0 mg/dl) levels and D-dimer / Fibrinogen ratios (12.25.9) of monoinfected dogs with Ehrlichiosis were found significantly elevated (P=0.011) in contrast to healthy dogs. In conclusion, it was suggested that the ratio of D-dimer/Fibrinogen in dogs with Ehrlichiosis monoinfection even combined with advanced diagnostic techniques, might become a biomarker that can shed light on the diagnostic significance of veterinary field thromboembolisms.

Anahtar Kelimeler

• D-dimer,D-dimer / Fibrinogen ratio,Dog,Ehrlichiosis,Thromboemboli

Ehrlichiosis’ li Köpeklerde D-dimer/Fibrinojen Oranı

Öz

Tromboemboliler kanama bozuklukları ile seyreden hastalıklarda mortalite düzeylerini etkileyen önemli sorunlardan biridir. Ehrlichiosis gibi kanama bozukluğuna neden olabilen hastalıklarda derin ven trombozları ve tromboembolilerin şekillendiği bilinmekte ancak tanının konulabilmesi için ileri diyagnostik tekniklere ihtiyaç duyulmaktadır. Bu çalışmada, Ehrlichiosis ile monoenfeksiyonlu köpeklerde D-dimer testi ile D-dimer/Fibrinojen oranlarının belirlenmesi amaçlandı. Bu amaçla yüksek ateş lenfadenopati ve iştahsızlık gibi klinik bulgular gösteren ve hasta başı hızlı ELİSA testi Snap 4dx sonuçlarına göre Ehrlichiosis ile monoenfeksiyonlu köpekler (n=10) ile klinik ve laboratuvar değerlendirmeleri sonucunda sağlıklı olduğu belirlenen (n=10) köpekler çalışmaya alındı. Çalışma gruplarında bulunan köpeklerden EDTA ve sitratlı kan örnekleri V.cephalica antebrachi üzerinden toplamda 5 ml olacak şekilde alınarak D-dimer ve Fibrinojen seviyeleri ticari test kitleri yardımı ile D-dimer/Fibrinojen oranı ise hesaplanarak elde edildi. Ehrlichiosis ile monoenfeksiyonlu köpeklerin D-dimer (3059.01074.4 ng/ml) ve Fibrinojen (371.062.0 mg/dl) seviyelerinin ve D-dimer/Fibrinojen oranlarının (12.25.9) sağlıklı köpeklere göre istatistiksel olarak (P=0.011) yüksek bulundu. Sonuç olarak Ehrlichiosis ile monoenfeksiyonlu köpeklerde D-dimer/Fibrinojen oranının ileri diyagnostik teknikler ile birleştirilerek Veteriner sahada tromboembolilerin tanısal anlamda yaklaşımına ışık tutabilecek biyobelirteçler arasına girebileceği düşünüldü.

Anahtar Kelimeler

• D-dimer,D-dimer/Fibrinojen oranı,Ehrlichiosis,Köpek,Tromboemboli

Kaynakça

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13. Griffin A., Callan MB., Shofer FS., Giger U., 2003. Evaluation of canine D-dimer point-of-care test kit for use in samples obtained from dogs with disseminated intravascular coagulation, thromboembolic disease, and hemorrhage. Am J Vet Res, 64, 1562–1569.
14. Ray P., Le Manach Y., Riou B., Houle TT., 2010. Statistical evaluation of a biomarker. Anesthesiology, 112, 1023–1040.
15. Ben S., Ni S., Shen H., Shi YX., Huang S., Xu J., Huang J., 2007. The dynamic changes of LDH isoenzyme 3 and D-dimer following pulmonary thromboembolism in canine. Thromb Res, 120, 575–583.
16. Arunthari V., Burger CD., 2009. Utility of D-dimer in the diagnosis of patients with chronic thromboembolic pulmonary hypertension. Open Respir Med J, 3, 85–89.
17. De Monye W., Sanson B., MacGillavery MR., Pattynama P., Buller H., Van Den Berg-huysmans A., Huisman MV., 2002. Embolus location affects the sensitivity of a rapid quantitative D-dimer assay in the diagnosis of pulmonary embolism. Am J Respir Crit Care Med, 165, 345–348.
18. Alvarez-Perez FJ., Castelo-Branco M., Alvarez-Sabin J., 2011. Usefulness of measurement of fibrinogen, D-dimer, D-dimer/fibrinogen ratio, C reactive protein and erythrocyte sedimentation rate to assess the pathophysiology and mechanism of ischaemic stroke. J Neurol Neurosurg Psychiatry,  82, 986-992.
19. Abcarian PW., Sweet JD., Watabe JT., Yoon HC., 2004. Role of a quantitative D-dimer assay in determining the need for CT angiography for acute pulmonary embolism. AJR Am J Roentgenol, 182, 1377–1381.
20. Ben S., Ni S., Shen H., Shi YX., Huang S., Xu J., Huang J., 2007. The dynamic changes of LDH isoenzyme 3 and D-dimer following pulmonary thromboembolism in canine. Thromb Res, 120, 575–583.
21. Arunthari V., Burger CD., 2009. Utility of D-dimer in the diagnosis of patients with chronic thromboembolic pulmonary hypertension. Open Respir Med J, 3, 85–89.
22. De Monye W., Sanson B., MacGillavery MR., Pattynama P., Buller H., Van Den Berg-huysmans A., Huisman MV., 2002. Embolus location affects the sensitivity of a rapid quantitative D-dimer assay in the diagnosis of pulmonary embolism. Am J Respir Crit Care Med, 165, 345–348.
23. Alvarez-Perez FJ., Castelo-Branco M., Alvarez-Sabin J., 2011. Usefulness of measurement of fibrinogen, D-dimer, D-dimer/fibrinogen ratio, C reactive protein and erythrocyte sedimentation rate to assess the pathophysiology and mechanism of ischaemic stroke. J Neurol Neurosurg Psychiatry,  82, 986-992.
24. Abcarian PW., Sweet JD., Watabe JT., Yoon HC., 2004. Role of a quantitative D-dimer assay in determining the need for CT angiography for acute pulmonary embolism. AJR Am J Roentgenol, 182, 1377–1381.
25. Ben S., Ni S., Shen H., Shi YX., Huang S., Xu J., Huang J., 2007. The dynamic changes of LDH isoenzyme 3 and D-dimer following pulmonary thromboembolism in canine. Thromb Res, 120, 575–583.
26. Arunthari V., Burger CD., 2009. Utility of D-dimer in the diagnosis of patients with chronic thromboembolic pulmonary hypertension. Open Respir Med J, 3, 85–89.
27. De Monye W., Sanson B., MacGillavery MR., Pattynama P., Buller H., Van Den Berg-huysmans A., Huisman MV., 2002. Embolus location affects the sensitivity of a rapid quantitative D-dimer assay in the diagnosis of pulmonary embolism. Am J Respir Crit Care Med, 165, 345–348.
28. Alvarez-Perez FJ., Castelo-Branco M., Alvarez-Sabin J., 2011. Usefulness of measurement of fibrinogen, D-dimer, D-dimer/fibrinogen ratio, C reactive protein and erythrocyte sedimentation rate to assess the pathophysiology and mechanism of ischaemic stroke. J Neurol Neurosurg Psychiatry,  82, 986-992.
29. Abcarian PW., Sweet JD., Watabe JT., Yoon HC., 2004. Role of a quantitative D-dimer assay in determining the need for CT angiography for acute pulmonary embolism. AJR Am J Roentgenol, 182, 1377–1381.