高球蛋白血症

赵博

Hyperglobulinemia

高球蛋白血症

作者：Julie Allen, BVMS, MS, MRCVS, DACVIM (SAIM), DACVP

翻译：陈坚（363305633）

校对：赵博

Following are differential diagnoses for patients presented with hyperglobulinemia. Hyperglobulinemia can be caused by monoclonal or polyclonal gammopathies; serum electrophoresis is required for differentiation and can help prioritize possible diagnoses. Polyclonal gammopathies are composed of nonalbumin proteins (ie, globulins) and are typically caused by inflammation, infection, or immune stimulation. Monoclonal gammopathies typically result from production of a single type of globulin protein and are most commonly associated with neoplastic causes, although rare non-neoplastic causes have also been described.

以下是高球蛋白血症患病动物的鉴别诊断。高球蛋白血症可由单克隆或多克隆丙种球蛋白病引起；需要血清电泳鉴别，可帮助将可能的诊断排序。多克隆丙种球蛋白病由非白蛋白的蛋白质（即球蛋白）组成，通常由炎症、感染或免疫刺激引起。单克隆丙种球蛋白病通常由产生单一类型的球蛋白引起，最常与肿瘤原因相关，尽管也有罕见的非肿瘤原因被报告。

Acute-phase reactant response (ie, tissue injury of any cause [eg, inflammation, acute bacterial or viral infection, necrosis, neoplasia, trauma]; typically mild)

急性期反应物的反应（即任何原因引起的组织损伤[如炎症、急性细菌或病毒感染、坏死、肿瘤、创伤]；通常为轻度）

Chronic antigenic stimulation/inflammation

慢性抗原刺激/炎症

Bacterial endocarditis

细菌性心内膜炎

Chronic skin disease

慢性皮肤病

Immune-mediated disease (eg, systemic lupus erythematosus, immune-mediated hemolytic anemia)

免疫介导性疾病（如系统性红斑狼疮、免疫介导的溶血性贫血）

Infectious disease (eg, FIP, leishmaniasis, heartworm disease, coccidioidomycosis, ehrlichiosis, hepatozoonosis, pythiosis, bartonellosis)

感染性疾病（例如FIP、利什曼病、心丝虫病、球孢子菌病、埃里希体病、肝簇虫病、腐皮病、巴尔通体病）

Liver disease (eg, lymphocytic cholangitis)

肝脏疾病（如淋巴细胞性胆管炎）

Severe dental disease

重度牙病

Hemoconcentration (concurrent increase in albumin)

血液浓缩（白蛋白同时升高）

Nephrotic syndrome

肾病综合征

Paraproteinemia (due to abnormal immunoglobulin production resulting in a monoclonal gammopathy)

副蛋白血症（由于免疫球蛋白生成异常导致单克隆丙种球蛋白病）

• Infectious disease-associated monoclonal gammopathies (usually immunoglobulin G; eg, Dirofilaria immitis, Ehrlichia canis, visceral leishmaniasis)

•感染性疾病相关单克隆丙种球蛋白病（通常为免疫球蛋白G；如犬恶丝虫、犬埃立克体、内脏型利什曼病）

• Inflammatory disease (eg, lymphoplasmacytic enteritis, cutaneous amyloidosis; rare)

•炎性疾病（如淋巴浆细胞性肠炎、皮肤淀粉样变；罕见）

Neoplasia

肿瘤

Chronic lymphocytic leukemia

慢性淋巴细胞白血病

Extramedullary plasmacytoma that affects the skin (dogs), GI tract, or liver

累及皮肤（犬）、胃肠道或肝脏的髓外浆细胞瘤

Lymphoma

淋巴瘤

Multiple myeloma

多发性骨髓瘤

Waldenström macroglobulinemia

华氏巨球蛋白血症

References

参考文献

Moore AR, Avery PR. Protein characterization using electro- phoresis and immunofixation; a case-based review of dogs and cats. Vet Clin Pathol. 2019;48(Suppl 1):29-44.

Riemer F, Kuehner KA, Ritz S, Sauter-Louis C, Hartmann K. Clin- ical and laboratory features of cats with feline infectious peritonitis—a retrospective study of 231 confirmed cases (2000-2010). J Feline Med Surg. 2016;18(4):348-356.

Rout ED, Shank AM, Waite AH, Siegel A, Avery AC, Avery PR. Progression of cutaneous plasmacytoma to plasma cell leukemia in a dog. Vet Clin Pathol. 2017;46(1):77-84.

Stockham SL, Scott MA. Proteins. In: Stockham SL, Scott MA. Fundamentals of Veterinary Clinical Pathology. 2nd ed. Ames, IA: Blackwell Publishing; 2008:379-404.

Whittemore JC, Hawley JR, Radecki SV, Steinberg JD, Lappin MR. Bartonella species antibodies and hyperglobulinemia in privately owned cats. J Vet Intern Med. 2012;26(3):639-644.

廊坊永鑫罗玄

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