Acta Veterinaria Hungarica
Volume/Issue:
Volume 68: Issue 3
Combination therapy with azathioprine, cyclosporine and ketoconazole in a dog with concurrent pemphigus foliaceus and hyperadrenocorticism – Case report
Authors:
Taesik Yun Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea

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Yoonhoi Koo Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea

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Sanggu Kim Department of Veterinary Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea

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Hakhyun Kim Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea

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Soochong Kim Department of Veterinary Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea

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Ji-Houn Kang Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea

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Mhan-Pyo Yang Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea

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Byeong-Teck Kang Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea

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https://orcid.org/0000-0002-4471-4342
Pages:
251–256
Online Publication Date:
30 Sep 2020
Publication Date:
30 Sep 2020
Article Category:
Case Report
DOI:
https://doi.org/10.1556/004.2020.00047
Keywords:
azathioprine; cyclosporine; dog; hyperadrenocorticism; ketoconazole; pemphigus foliaceus
Restricted access

Abstract

A 10-year-old, spayed female Shih Tzu dog presented with a history of progressive erythema and multiple crusts developing 85 days previously. The dog had been diagnosed with hyperadrenocorticism (HAC) 55 days prior to presentation and was treated with oral trilostane (2.86 mg/kg, once daily) that was discontinued due to a poor response. In addition to generalised alopecia, erythematous plaques and crusts were noted on the trunk, head and footpads. Lesional impression smears revealed numerous acantholytic cells and non-degenerated neutrophils. Histopathological findings demonstrated subcorneal pustules with acantholytic cells and intact neutrophils. On the basis of these findings, we diagnosed pemphigus foliaceus (PF) with concurrent HAC. We wished to avoid glucocorticoids and, therefore, prescribed oral, once-daily azathioprine (2 mg/kg), modified cyclosporine (7 mg/kg) and ketoconazole (5 mg/kg). By day 71 post-treatment, the erythematous crusts had almost disappeared and the alopecia had improved considerably. However, by the subsequent follow-up examination on day 99, the clinical signs had reappeared due to the tapering of cyclosporine. To the best of our knowledge, this is the first case report describing concurrent PF and HAC in a dog. Combination therapy with azathioprine, modified cyclosporine and ketoconazole was effective, and should be considered for dogs diagnosed with concurrent autoimmune diseases and HAC.

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Cover Acta Veterinaria Hungarica
Acta Veterinaria Hungarica
Print ISSN:
0236-6290
Online ISSN:
1588-2705

Senior editors

Editor-in-Chief: Ferenc BASKA

Editorial assistant: Szilvia PÁLINKÁS

 

Editorial Board

  • Mária BENKŐ (Acta Veterinaria Hungarica, Budapest, Hungary)
  • Gábor BODÓ (University of Veterinary Medicine, Budapest, Hungary)
  • Béla DÉNES (University of Veterinary Medicine, Budapest Hungary)
  • Edit ESZTERBAUER (Veterinary Medical Research Institute, Budapest, Hungary)
  • Hedvig FÉBEL (University of Veterinary Medicine, Budapest, Hungary)
  • László FODOR (University of Veterinary Medicine, Budapest, Hungary)
  • János GÁL (University of Veterinary Medicine, Budapest, Hungary)
  • Balázs HARRACH (Veterinary Medical Research Institute, Budapest, Hungary)
  • Peter MASSÁNYI (Slovak University of Agriculture in Nitra, Nitra, Slovak Republic)
  • Béla NAGY (Veterinary Medical Research Institute, Budapest, Hungary)
  • Tibor NÉMETH (University of Veterinary Medicine, Budapest, Hungary)
  • Zsuzsanna NEOGRÁDY (University of Veterinary Medicine, Budapest, Hungary)
  • Dušan PALIĆ (Ludwig Maximilian University, Munich, Germany)
  • Alessandra PELAGALLI (University of Naples Federico II, Naples, Italy)
  • Kurt PFISTER (Ludwig-Maximilians-University of Munich, Munich, Germany)
  • László SOLTI (University of Veterinary Medicine, Budapest, Hungary)
  • József SZABÓ (University of Veterinary Medicine, Budapest, Hungary)
  • Péter VAJDOVICH (University of Veterinary Medicine, Budapest, Hungary)
  • János VARGA (University of Veterinary Medicine, Budapest, Hungary)
  • Štefan VILČEK (University of Veterinary Medicine in Kosice, Kosice, Slovak Republic)
  • Károly VÖRÖS (University of Veterinary Medicine, Budapest, Hungary)
  • Herbert WEISSENBÖCK (University of Veterinary Medicine, Vienna, Austria)
  • Attila ZSARNOVSZKY (Szent István University, Gödöllő, Hungary)

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Acta Veterinaria Hungarica
Language English
Size A4
Year of
Foundation		 1951
Volumes
per Year		 1
Issues
per Year		 4
Founder Magyar Tudományos Akadémia
Founder's
Address		 H-1051 Budapest, Hungary, Széchenyi István tér 9.
Publisher Akadémiai Kiadó
Publisher's
Address		 H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher		 Chief Executive Officer, Akadémiai Kiadó
ISSN 0236-6290 (Print)
ISSN 1588-2705 (Online)

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