Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
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Evans' Syndrome Induced by Rabies Vaccination in a Dog

  • Yeji Kim (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chonnam National University) ;
  • Jihyun Kim (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chonnam National University) ;
  • Yunji Song (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chonnam National University) ;
  • Songju Oh (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chonnam National University) ;
  • Ha-Jung Kim (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chonnam National University)
  • Received : 2023.06.20
  • Accepted : 2023.07.31
  • Published : 2023.08.31
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Abstract

A 11-year-old neutered male Maltese dog was vaccinated with a rabies vaccine (Rabisin®, Boehringer Ingelheim International GmbH, Germany) subcutaneously at a local animal hospital. One hour after vaccination, purpura with edema was observed at the injection site and severe thrombocytopenia (0 K/μL) was noted on a complete blood count (CBC). No specific findings were found in serum chemistry, electrolyte, blood gas analysis, and coagulation tests. The patient was hospitalized and administered antihemorrhagic agents (vitamin K, desmopressin), antihistamines (chlorpheniramine) and corticosteroids (methylprednisolone sodium succinate). On a repeat CBC, mild anemia had developed, thrombocytopenia was still noted, and autoagglutination was observed on a saline agglutination test (SAT). A polymerase chain reaction panel for infectious agents (e.g., Babesia spp.) was negative. The diagnosis was secondary immune-mediated thrombocytopenia (IMT) with immune-mediated hemolytic anemia (IMHA) associated with vaccination. Therefore, the immunosuppressants (prednisolone, and mycophenolate mofetil) were administered. Six days after drug administration, new lesion was not observed, and the previous lesions were significantly improved. It gradually improved and 4 weeks after hematocrit and platelet recovered to normal levels. It was maintained for 6 months without recurrence of related symptoms. Based on patient's history and test results, the patient was diagnosed with Evans' syndrome associated with rabies vaccine.

Keywords

Acknowledgement

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (NRF-2023R1A2C1005348).

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