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Case Reports
. 2023 Sep;13(9):1205-1211.
doi: 10.5455/OVJ.2023.v13.i9.16. Epub 2023 Sep 30.

Complete remission of two canine cases with precursor-targeted immune-mediated anemia after combination therapy with prednisolone, cyclosporine, and oclacitinib

Masashi Yuki  1   2 , Hiroto Taira  1 , Momoko Narita  1 , Takanori Inden  1 , Shunya Yokota  1   2 , Eiji Naito  1 , Sadatoshi Maeda  2
Affiliations
Case Reports

Complete remission of two canine cases with precursor-targeted immune-mediated anemia after combination therapy with prednisolone, cyclosporine, and oclacitinib

Masashi Yuki et al. Open Vet J. 2023 Sep.

Abstract

Background: Precursor-targeted immune-mediated anemia (PIMA) has been described in dogs presenting with nonregenerative anemia and evidence of ineffective erythropoiesis. Although it has been suggested that its occurrence may be related to the immune targeting of erythroid precursors, this pathogenesis has not been established. PIMA is mainly treated with glucocorticoids, and in cases where glucocorticoids alone are not effective, immunosuppressants are also used as combination therapy. However, not all cases of PIMA go into remission after these treatments.

Case description: Two dogs with severe nonregenerative anemia diagnosed as PIMA based on the results of clinical pathological examinations, including bone marrow examination, were treated with whole-blood transfusion and immunosuppressive doses of prednisolone, mycophenolate mofetil, and cyclosporine. However, these treatments failed to achieve remission of PIMA. Therefore, concomitant administration of oclacitinib, which is a Janus kinase-1 inhibitor that has been applied recently to the treatment of immune-mediated diseases, was performed; this combined regimen improved the anemia and achieved complete remission of PIMA.

Conclusion: Oclacitinib may be an option for the treatment of PIMA in dogs failing to achieve remission with conventional immunosuppressive therapy.

Keywords: Cyclosporine; Dog; Oclacitinib; Precursor-targeted immune-mediated anemia; Prednisolone.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Fig. 1.
Fig. 1.. Dynamic change in the hematocrit (case 1). PSL = prednisolone; MMF = mycophenolate mofetil; CsA = cyclosporine A.
Fig. 2.
Fig. 2.. (a) Dynamic Change in the hematocrit (case 2). PSL = prednisolone; MMF = mycophenolate mofetil; CsA = cyclosporine A.
See this image and copyright information in PMC

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