ACVIM consensus statement on the treatment of immune‐mediated hemolytic anemia in dogs
Consenso do ACVIM sobre o tratamento da anemia hemolítica imunomediada em cães
James W. Swann, Oliver A. Garden, Claire L. Fellman, Barbara Glanemann, Robert Goggs, Dana N. LeVine, Andrew J. Mackin, Nathaniel T. Whitley
Immune-mediated hemolytic anemia (IMHA) causes severe anemia in dogs and isassociated with considerable morbidity and mortality. Treatment with various immu-nosuppressive and antithrombotic drugs has been described anecdotally and in previ-ous studies, but little consensus exists among veterinarians as to the optimal regimento employ and maintain after diagnosis of the disease. To address this inconsistencyand provide evidence-based guidelines for treatment of IMHA in dogs, we identifiedand extracted data from studies published in the veterinary literature. We developed anovel tool for evaluation of evidence quality, using it to assess study design, diagnosticcriteria, explanation of treatment regimens, and validity of statistical methods. In com-bination with our clinical experience and comparable guidelines for humans afflictedwith autoimmune hemolytic anemia, we used the conclusions of this process to makea set of clinical recommendations regarding treatment of IMHA in dogs, which werefined subsequently by conducting several iterations of Delphi review. Additionally,we considered emerging treatments for IMHA in dogs and highlighted areas deservingof future research. Comments were solicited from several professional bodies to maxi-mize clinical applicability before the recommendations were submitted for publication.The resulting document is intended to provide clinical guidelines for management ofIMHA in dogs. These guidelines should be implemented pragmatically, with consider-ation of animal, owner, and veterinary factors that may vary among cases.
AIHA, azathioprine, canine, cyclosporine, guideline, IMHA, mycophenolate mofetil, prednisolon
AIHA, azatioprina, canino, ciclosporina, diretriz, IMHA, micofenolato de mofetil, prednisolon