Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
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Long-term Management of Copper-associated Hepatic Cirrhosis with D-penicillamine, SAMe, and DBB in a Dog

개에서 발생한 구리 축적성 간경화에 D-penicillamine, SAMe, DBB로 병용 치료하여 장기간 생존한 1례

  • Seo, Kyoung-Won (Departments of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University) ;
  • Lee, Young-Heun (Departments of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University) ;
  • Bhang, Dong-Ha (Departments of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University) ;
  • Ahn, Jin-Ok (Departments of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University) ;
  • Coh, Ye-Rin (Departments of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University) ;
  • Hwang, Cheol-Young (Departments of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University) ;
  • Kim, Dea-Yong (Department of Veterinary Pathology, College of Veterinary Medicine, Seoul National University) ;
  • Youn, Hwa-Young (Departments of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University)
  • 서경원 (서울대학교 수의과대학 내과학교실) ;
  • 이영흔 (서울대학교 수의과대학 내과학교실) ;
  • 방동하 (서울대학교 수의과대학 내과학교실) ;
  • 안진옥 (서울대학교 수의과대학 내과학교실) ;
  • 고예린 (서울대학교 수의과대학 내과학교실) ;
  • 황철용 (서울대학교 수의과대학 내과학교실) ;
  • 김대용 (서울대학교 수의과대학 병리학교실) ;
  • 윤화영 (서울대학교 수의과대학 내과학교실)
  • Accepted : 2011.04.12
  • Published : 2011.04.30
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Abstract

A 4-year-old intact female American Cocker Spaniel presented with lack of appetite, shivering, and abdominal distension. It was initially diagnosed with chronic hepatitis with cirrhosis, by serum chemistry, radiography, ultrasonography, and histopathologic examination following liver biopsy. Abundant copper granules were detected in most hepatocytes with rhodanine stain, with hepatic copper concentration at 1460 ppm (reference range: <400 ppm). Based on these findings, copper-associated hepatitis with cirrhosis was diagnosed and successfully managed with long-term D-penicillamine, s-adenosylmethionine, biphenyl-dimethyl-dicarboxylate and supportive care. The spaniel died 35 months after diagnosis.

4살령의 아메리칸 코가 스파니엘이 식욕부진, 몸떨림 그리고 복부 팽만증세로 내원하였다. 혈청학적 검사, 방사선 검사, 초음파 검사 그리고 간생검을 통한 조직병리학적 검사를 통해 경화로 진행된 만성 간염으로 진단할 수 있었으며, 특수 염색법을 통해 대부분의 간세포내에 구리가 축적되어 있는 것을 확인할 수 있었으며, 구리 농도는 1460 ppm으로 매우 높음을 알 수 있었다. 이러한 검사 결과를 바탕으로 구리 축적으로 인한 간염이 간경화까지 진행된 말기 병변으로 진단하고 D-penicillamine, s-adenosymethionine, biphenyl-dimethyl-dicarboxylate과 대증 치료로 본 환자를 치료 하였으며, 본 환자는 진단 후 35개월을 생존하는 것에 성공하였다.

Keywords

References

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