Date Published: June 21, 2006
Publisher: BioMed Central
Author(s): Mads Kjelgaard-Hansen, Asger Lundorff Jensen, Geoffrey A Houser, Lisbeth Rem Jessen, Annemarie T Kristensen.
Monitoring systemic inflammatory activity during steroid therapy of canine immune-mediated polyarthritis (IMPA) is difficult and mainly relies on clinical signs.
Canine serum C-reactive protein (CRP) was measured serially and blinded during a 27-week follow-up period of a case of Anaplasma phagocytophilia induced type II immune-mediated polyarthritis.
WBC was, as expected, observed not to reflect the inflammatory activity during steroid treatment in a clinical useful manner, whereas, CRP is suggested a valuable unbiased marker of inflammatory activity during steroid treatment in this case.
Monitoring systemic inflammatory activity during steroid therapy of canine immune-mediated diseases may be difficult. The clinician mainly has to rely on clinical signs  since objective fast-reacting inflammatory markers (white blood cell count [WBC] and absolute numbers of granulocytes) usually are so affected by the steroid treatment per se  that they are inadequate for reliable monitoring. Thus, a fast-reacting objective inflammatory marker not biased by steroids could potentially be of clinical value.
Infections of Ehrlichia spp. (Anaplasma spp.) were reported as a cause of type II IMPA in dogs  where it is assumed that the infectious process provides an antigenic source for immune complex formation, and either the antigen or circulating complexes are deposited within the synovium to initiate inflammation by a type III hypersensitivity reaction . The involvement of A. phagocytophilum in the present diagnosis was based on clinical signs, cytological findings and a positive antibody titer against Ehrlichia equi (A. phagocytophilum ), but a negative PCR for Ehrlichia spp. antigen was also obtained. However, negative PCR was reported to be common even after short antibiotic treatment .
The author(s) declare that they have no competing interests.
GAH, LRJ and ATK were responsible for patient-management throughout the period of diagnosis and treatment. MKH and ALJ were responsible for the clinical pathological analyses and study design regarding CRP. All authors have been significantly involved in interpretation of data and drafting the manuscript. All authors have given final approval of the manuscript.