(HM12) Nucleated Rbcs as a Diagnostic and Prognostic Biomarker in Canine Systemic Inflammatory Response Syndrome

Abstract:

Background: nucleated red blood cells (nRBCs) are immature erythrocytes that can be increased by pathologic process as well as hematopoietic stress.

Hypothesis/

Objectives: To evaluate the potency of nRBCs as a diagnostic and prognostic indicator in canine systemic inflammatory response syndrome (SIRS).

Animals: Sixty-two client owned dogs met the criteria for SIRS without anemia.

Methods: Medical records were retrospectively reviewed. Dogs were classified into nRBC-positive dogs (n = 32) and nRBC-negative dogs (n = 30) based on blood films. Clinicopathological data, acute patient physiologic and laboratory evaluation (APPLEfast) score, and concentrations of cytokines including Interleukin (IL)-3, IL-6, and erythropoietin were compared between two groups. Survival rate analysis and receiver operating characteristic curve were used to investigate the prognostic value of circulating nRBCs.

Results: nRBC-positive dogs (n = 32) showed more severe inflammation compared to nRBC-negative dogs (n = 30): higher white blood cells, neutrophils, and band neutrophils; higher plasma C-reactive protein, and IL-6; lower plasma albumin (all of the above, P < 0.05). The mean reticulocyte counts (P < 0.01) and concentrations of IL-3 (P < 0.05) were also significantly greater in nRBC-positive dogs. Survival time was considerably shorter in the nRBC-positive dogs (P = 0.03). Circulating nRBCs at admission predicted negative outcome in dogs with SIRS at 4 weeks (area under the curve [AUC]: 0.73, confidence interval [CI]: 0.59-0.87).

Conclusions and Clinical Importance: Assessing peripheral nRBCs in canine SIRS is a rapid clinically-applicable indices that reflect the severity of systemic inflammation.