Screening diagnostics to identify triggers in 21 cases of steroid-responsive meningitis-arteritis

OBJECTIVES: To evaluate whether screening tests used to identify infectious and neoplastic triggers for immune-mediated haemolytic anaemia, in particular a complete blood count and differential, serum biochemistry profile, urine analysis (including culture), abdominal ultrasound and thoracic radiographs, can identify triggers for steroid-responsive meningitis-arteritis.

METHODS: Retrospective descriptive review.

RESULTS: Twenty-one steroid-responsive meningitis-arteritis cases were identified in which all screening tests had been performed. All cases had changes in complete blood count (including neutrophilia, monocytosis, lymphocytosis, eosinopenia or anaemia); 19 had changes in biochemistry (including hypoalbuminaemia, hyperglobulinaemia, increased alkaline phosphatase activity, hyperphosphataemia, increased total calcium concentration, hypercholesterolaemia, hyperkalaemia, increased urea concentration and increased alanine aminotransferase activity); two cases had an elevated urine protein to creatinine ratio but none had positive urine culture results; no cases had abnormalities on orthogonal radiographs of the thorax; four cases had abnormalities identified on abdominal ultrasound, which following cytological examination suggested inflammation in the absence of pathological organisms.

CLINICAL SIGNIFICANCE: Screening tests used to identify infectious and neoplastic triggers in immune-mediated haemolytic anaemia did not isolate triggers for steroid-responsive meningitis-arteritis in the population of dogs under investigation.