Il presente studio retrospettivo ha confermato il rilievo delle principali alterazioni cliniche e clinico-patologiche riportate in letteratura, introducendo però una novità: lo studio dei ratio come marker infiammatori in una patologia non neoplastica.
I due gruppi di pazienti, 48 provenienti dall’ODV e 43 dallo Small Animal Hospital, si presentavano molto disomogenei, rendendo difficile il confronto. Sesso, condizione sessuale e peso, per cui sono state riscontrate differenze significative, rappresentano potenziali fattori di confondimento, rendendo, purtroppo, meno validi i risultati ottenuti. Al momento della prima visita i due gruppi sono risultati differenti per BCS, polso e colore delle mucose (categoria leggermente pallide); la stadiazione secondo i sistemi CHAOS e Tokyo score ha evidenziato una differenza significativa solo per un punteggio di 2 del Tokyo score. La differenza significativa riscontrata per l’ospedalizzazione al momento della prima visita, con una maggiore percentuale di soggetti ospedalizzati nel gruppo “Texas” rispetto al gruppo “Tuscany”, rispecchia l’andamento generale dei risultati di questo studio. Infatti, i cani del gruppo “Texas” presentavano condizioni cliniche e clinico-patologiche più gravi, portando a differenze significative per numero di linfociti ed eosinofili, frequenza di osservazione di monocitosi, presenza di sferociti ed emolisi, valori di PT, proteine totali, globuline, AGR, Ca totale, fosfati, creatinina e ALT.
Anche la significatività per MCV e MCHC può rappresentare un fattore di confondimento, in quanto ha portato alla riduzione del numero dei casi valutati nel gruppo “Texas”; ciononostante la prevalenza nel gruppo “Tuscany” di un’anemia di tipo macrocitico ipocromica risulta in linea con la bibliografia.
Per le urine i risultati, significativi per metodo di prelievo, presenza di proteinuria, bilirubinuria, sangue e cellule squamose, sono di più difficile interpretazione, sebbene la presenza di proteinuria, bilirubinuria e sangue si presentino in linea con la patologia. Occorre precisare che il metodo di prelievo e le cellule squamose sono condizioni pre- analitiche.
I ratio leucocitari e piastrinici (NLR, NER, LMR e PLR), applicati per la prima volta nell’IMHA, sono risultati tutti significativi nel confronto tra i due gruppi.
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La correlazione tra una serie di fattori prognostici e la sopravvivenza al momento della dimissione è risultata in generale in linea con la bibliografia; aumento di peso, temperatura, emolisi, sferocitosi, parametri della coagulazione, valori di proteine totali, bilirubina totale e ALP, e la riduzione di piastrine e dell’IR risultano infatti correlate con l’aumento della probabilità di non sopravvivenza. Purtroppo i ratio non hanno fornito informazioni prognostiche.
Per concludere, questo studio ci permette di individuare un’utilità dei ratio leucocitari e piastrinici come marker infiammatori anche in patologie non neoplastiche, quale appunto l’IMHA; le differenze significative riscontrate nei due gruppi possono essere ricondotte a un più grave stato infiammatorio presente nei soggetti del gruppo “Texas”. Pertanto, potrebbero essere utilizzati per distinguere soggetti in condizioni cliniche più gravi e influenzare quindi l’approccio terapeutico iniziale per questa patologia.
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