Peer-reviewed veterinary case report
Dog with kidney injury and swelling after human serum albumin
By Sänger, Florian et al.·Published in Frontiers in veterinary science·2025·LMU Small Animal Clinic, Germany·View original on PubMed →
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Original publication title: Case Report: Management of a delayed type III hypersensitivity reaction with acute kidney injury in a dog after administration of human serum albumin with immunoadsorption.
- Species:
- dog
Plain-English summary
A 6-year-old male German Shepherd was brought in with swelling all over his body and signs of kidney injury after receiving a treatment called human serum albumin two weeks earlier. He showed symptoms like low energy, bruising, and bleeding in his eyes. Tests revealed severe kidney issues and the presence of antibodies against the serum albumin. The dog underwent a special treatment called immunoadsorption to remove the harmful antibodies, followed by hemodialysis to support his kidneys. After 10 days of treatment, he improved significantly, with his kidney function returning to normal levels two weeks after going home.
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Abstract
A six-year-old, intact male German Shepherd, weighing 43 kg, was presented with generalized edema formation and acute kidney injury due to a suspected delayed type III hypersensitivity reaction and vasculitis 2 weeks after the administration of human serum albumin (HSA). At presentation, the patient had a moderately reduced general condition, a heart rate of 96/min, rectal temperature of 37.0 °C, generalized edema, hematoma and petechiae on all limbs and the abdomen, and scleral hemorrhage. The initial blood work showed a moderate anemia, a severe azotemia, and a moderate hypoalbuminemia. Marked proteinuria with a urine protein-creatinine ratio (UPC) of 6.26 was present. The presence of anti-HSA antibodies was proven with an in-house ELISA. For treatment, immunoadsorption (IA) was performed with the TheraSorb® Ig Omni 1 adsorber, which was integrated in the LIFE 21® apheresis unit. Due to severe azotemia, an intermittent hemodialysis treatment with the dialysis platform Fresenius 4008 was performed after IA. Both treatments were repeated on the following day. A total plasma volume of 1.9 liters and 3.7 liters, respectively, was processed with IA. On the following days, creatinine concentration declined and the patient improved significantly. The patient was discharged after 10 days. UPC decreased to 0.82 and edema completely resolved. Two weeks after discharge, Creatinine, UPC and albumin were in the reference range. IA might be an additional therapeutic option for dogs with severe acute kidney injury due to a suspected delayed type III hypersensitivity reaction.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/41158946/