Premium
Complete heart block associated with lupus in a dog
Author(s) -
MALIK R,
ZUNINO P,
HUNT GB
Publication year - 2003
Publication title -
australian veterinary journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.382
H-Index - 59
eISSN - 1751-0813
pISSN - 0005-0423
DOI - 10.1111/j.1751-0813.2003.tb11544.x
Subject(s) - medicine , heart block , lethargy , atrioventricular block , systemic lupus erythematosus , azathioprine , myositis , etiology , immune system , endocarditis , lupus erythematosus , cardiology , immunology , gastroenterology , antibody , disease , electrocardiography
A 5‐year‐old Poodle‐cross was initially presented for exercise intolerance and difficulty in chewing and yawning. Some months later it acutely developed lethargy referable to complete heart block. Further investigations before and after permanent pacemaker implantation demonstrated Coombs‐positive immune‐mediated haemolytic anaemia, presumptive masticatory myositis and hypoadrenocorticism, suggesting the possibility of multisystem auto‐immune disease. A diagnosis of systemic lupus erythematosus (SLE) was made based on these findings and a positive anti‐nuclear antibody titre. It was thought that immune‐mediated destruction of cardiac conduction tissues was responsible for the development of atrioventricular conduction block. Glucocorticoid deficiency was corrected using cortisone replacement therapy. SLE was controlled successfully for 10 months using azathio‐prine monotherapy until signs, subsequently shown to be due to subacute bacterial endocarditis, resulted in the death of the patient. Lupus should be considered as a potential underlying aetiology in dogs that develop heart block.