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. 2023 Nov 18;85(11):1245-1251.
doi: 10.1292/jvms.23-0037. Epub 2023 Oct 2.

A case of cold agglutinin disease in a bottlenose dolphin (Tursiops truncatus)

Kenichiro Takubo  1 , Chika Shirakata  1   2
Affiliations

A case of cold agglutinin disease in a bottlenose dolphin (Tursiops truncatus)

Kenichiro Takubo et al. J Vet Med Sci. .

Abstract

Cold agglutinin disease, one of the serological classifications of immune-mediated hemolytic anemia, is caused by the production of autoantibodies that react with erythrocytes at low temperatures. A captive bottlenose dolphin presented with regenerative and hemolytic anemia. Anticoagulated whole blood was agglutinated at room temperature (approximately 18°C), with reversal of agglutination on warming to 37°C, indicating the presence of cold agglutinin. Based on these findings, this animal was diagnosed with cold agglutinin disease. Clindamycin, doxycycline, and prednisolone were administered orally to treat the infection and immune-mediated hemolytic anemia. Anemia gradually improved after initiation of pharmacotherapy, and erythrogenesis slowed as erythroblasts disappeared and reticulocyte count decreased in peripheral blood. This represents the first report of cold agglutinin disease in a cetacean.

Keywords: anemia; cold agglutinin disease; dolphin; immune-mediated hemolytic anemia.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

Fig. 1.
Fig. 1.
An erythrocyte ghost (arrowhead) on the blood smear collected on Day 2 (Giemsa stain, ×1,000).
Fig. 2.
Fig. 2.
Agglutinated whole blood of the bottlenose dolphin collected on Day 9 at room temperature (approximately 18°C) (left) and unagglutinated after warming to 37°C (right).
Fig. 3.
Fig. 3.
Dosing schedules of prednisolone, clindamycin (CLDM), and doxycycline (DOXY), and changes of complete blood counts and biochemical parameters. A: Dosing schedules and changes in red blood cell count (RBC), hematocrit (Ht), and hemoglobin (Hb). B: Dosing schedules and changes in mean corpuscular volume (MCV), reticulocyte count (Ret), and erythroblast appearance in peripheral blood. C: Dosing schedules and changes in aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), fibrinogen (Fib), and alkaline phosphatase (ALP). D: Dosing schedules and changes in α2 fraction fixed value of serum protein electrophoresis (α2), fibrinogen (Fib), and total bilirubin (T-Bil).
Fig. 4.
Fig. 4.
Erythrocyte suspension mixed with serum from the bottlenose dolphin (Tursiops truncatus) affected by cold agglutinin disease. A: Erythrocyte suspension mixed with serum from the same blood (Control) (×400). B: Agglutinated erythrocyte suspension mixed with serum from Day 1 (×400).
See this image and copyright information in PMC

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