Systemic lupus erythematosus

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Discoid nasal lesions in a dog with SLE[1]

Systemic lupus erythematosus (SLE) is a rare immune-mediated disease of dogs.

A predisposition is noted in German shepherd, Collie and Siberian Husky breeds.

Dogs in contact with human sufferers of SLE have a higher risk of developing SLE themselves, suggesting a common environmental factor or zoonotic agent[2].

SLE presents in dogs as a disease complex with immune-mediated history similar to canine pemphigus. SLE is associated with certain alleles and haplotypes of the dog leukocyte antigen (DLA), which includes the canine major histocompatibility complex (MHC) class II genes DRB1, DQA1 and DQB1[3].

Clinically affected dogs usually have various dermatopathies such as localized ulcerative and generalized exfoliative dermatitis[4], and systemic signs such as fever, inappetence, lethargy, arthralgia, myalgia, stiffness and multiple lesions[5]. Immune-mediated arthritis is a common sequela with this disease.

Less common systemic symptoms include steroid-responsive laryngeal paralysis[6], sterile nodular panniculitis[7] and glomerulonephritis[8].

Diagnosis usually requires histopathological testing of skin biopsies and demonstration of lymphocyte-rich interface dermatitis with epidermal atrophy and dermo-epidermal deposition of immunoglobulins and activated complement. Most dogs react positive histologically to anti-nuclear antibodies[9].

Oral prednisolone has long been held as the standard therapy for this disease, however, alternative methods have been employed.

Treatment with the antimalarial immunomodulator hydroxychloroquine (5 mg/kg once daily) augmented with topical 0.1% tacrolimus ointment for 2 weeks has been successful[10].

Restriction of access to direct sunlight during this period assists resolution of skin lesions.


References

  1. Bright Hub
  2. Chiou SH et al (2004) Pet dogs owned by lupus patients are at a higher risk of developing lupus. Lupus 13(6):442-449
  3. Safra N et al(2011) Expanded dog leukocyte antigen (DLA) single nucleotide polymorphism (SNP) genotyping reveals spurious class II associations. Vet J 189(2):220-226
  4. Bryden SL et al (2005) Clinical, histopathological and immunological characteristics of exfoliative cutaneous lupus erythematosus in 25 German short-haired pointers. Vet Dermatol 16(4):239-252
  5. Smee NM et al (2007) Measurement of serum antinuclear antibody titer in dogs with and without systemic lupus erythematosus: 120 cases (1997-2005). J Am Vet Med Assoc 230(8):1180-1183
  6. Kvitko-White H et al (2012) Acquired bilateral laryngeal paralysis associated with systemic lupus erythematosus in a dog. J Am Anim Hosp Assoc 48(1):60-65
  7. O'Kell AL et al (2010) Canine sterile nodular panniculitis: a retrospective study of 14 cases. J Vet Intern Med 24(2):278-284
  8. Vaden SL (2011) Glomerular disease. Top Companion Anim Med 26(3):128-134
  9. Malik R et al (2003) Complete heart block associated with lupus in a dog. Aust Vet J 81(7):398-401
  10. Oberkirchner U et al (2012) Successful treatment of a novel generalized variant of canine discoid lupus erythematosus with oral hydroxychloroquine. Vet Dermatol 23(1):65-70