Peer-reviewed veterinary case report
Presumptive phenobarbital-induced systemic lupus erythematosus in a domestic dog.
- Journal:
- Journal of veterinary internal medicine
- Year:
- 2023
- Authors:
- Phillips, Erin et al.
- Affiliation:
- Department of Clinical Studies · Canada
- Species:
- dog
Plain-English summary
A 3.5-year-old poodle was treated with phenobarbital for epilepsy but developed some serious health issues, including fever, low blood cell counts, and protein in the urine. Tests showed a positive result for antinuclear antibodies, which can indicate autoimmune diseases like systemic lupus erythematosus (a condition where the immune system attacks the body). After stopping the phenobarbital and starting a different medication called levetiracetam, the dog's symptoms improved significantly. Within three months, all the health problems resolved, and the dog returned to normal.
Abstract
CASE DESCRIPTION: We describe a case of presumptive acquired systemic lupus erythematosus secondary to phenobarbital administration in a dog, which resolved with withdrawal of the drug. CLINICAL FINDINGS: A 3.5 year-old poodle presented to a veterinary teaching hospital for Tier 1 idiopathic epilepsy and was treated with phenobarbital. The dog experienced fever, multiple cytopenias, and proteinuria in conjunction with a positive antinuclear antibody (ANA) titer. DIAGNOSTICS: Serial CBCs, urine protein : creatinine ratios, and sternal bone marrow aspirates were performed to evaluate improvement. TREATMENT AND OUTCOME: Phenobarbital was withdrawn and levetiracetam initiated. All abnormalities resolved with supportive care, without initiation of immunosuppressive drugs. All cytopenias and proteinuria resolved and ANA test results became negative within 3 months. The patient recovered and did well clinically. CLINICAL RELEVANCE: Systemic lupus erythematosus is a disease of multiple autoimmune syndromes occurring concurrently or sequentially in conjunction with the presence of circulating ANA. It has been well described in dogs as an idiopathic condition, but in human medicine may occur secondary to drug reactions (drug-associated lupus) including as a reaction to phenobarbital. The findings in our case are consistent with the criteria for drug-induced lupus in humans and we suggest it as the first report of phenobarbital-induced lupus in a dog.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/37737539/