title: Canine pemphigus foliaceus with concurrent immune-mediated thrombocytopenia.
abstract: A 3 yr old wirehaired fox terrier was presented to his primary care veterinarian with fever, thrombocytopenia, and generalized crusting dermatitis. The skin lesion had progressed for at least 18 days, and thrombocytopenia had developed 3 days before presentation. Histopathology and direct immunofluorescence studies of the skin were consistent with pemphigus foliaceus (PF). Immunofluorescence revealed immunoglobulin G deposition around the keratinocytes in the stratum spinosum. A diagnosis of immune-mediated thrombocytopenia (IMT) was confirmed by the presence of platelet surface-associated immunoglobulin using flow cytometry. Systemic immunosuppressive therapy with cyclosporine and azathioprine was effective, and the dog survived for >2 years from the initial presentation. IMT is rarely associated with PF. This appears to be the first detailed report of a definitive diagnosis of concurrent PF and IMT in a dog. The authors' findings indicate that canine PF could be complicated by hematologic immune-mediated diseases such as IMT.
authors.affiliation: From Laboratory of Small Animal Clinics, Veterinary Teaching Hospital (S.K., T.I., H.M.) and Laboratory of Veterinary Internal Medicine II (M.H., Y.I., S.N., R.T.), Laboratory of Veterinary Surgery I (Y.F.), and Laboratory of Veterinary Pathology (K.S.), Department of Veterinary Medicine, Azabu University, Fuchinobe, Chuo-ku, Sagamihara, Kanagawa, Japan; and Center for Advanced Biomedical Research, Boston University School of Medicine, Boston, MA (S.M.).
authors.forename: Shinpei
authors.initials: S
authors.lastname: Kawarai
authors.forename: Masaharu
authors.initials: M
authors.lastname: Hisasue
authors.forename: Shinobu
authors.initials: S
authors.lastname: Matsuura
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Ito
authors.forename: Yukari
authors.initials: Y
authors.lastname: Inoue
authors.forename: Sakurako
authors.initials: S
authors.lastname: Neo
authors.forename: Yoko
authors.initials: Y
authors.lastname: Fujii
authors.forename: Hiroo
authors.initials: H
authors.lastname: Madarame
authors.forename: Kinji
authors.initials: K
authors.lastname: Shirota
authors.forename: Ryo
authors.initials: R
authors.lastname: Tsuchiya
mesh_terms: D000818:Animals; D001379:Azathioprine / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D004283:Dog Diseases / Q000188:drug therapy / Q000473:pathology*; D004285:Dogs; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D010392:Pemphigus / Q000188:drug therapy / Q000473:pathology / Q000662:veterinary*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy / Q000473:pathology / Q000662:veterinary*
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D001379:Azathioprine