病例報告：馬爾濟斯犬合併內水腦症及肉芽腫性腦膜腦炎一例

內水腦症(Internal hydrocephalus)合併肉芽腫性腦膜腦炎(granulomatous meningoencephalomyelitis; GME)為罕見及生前不易診斷之疾病。本報告描述一隻2歲大、2公斤重，未結紮馬爾濟斯公犬，就診時出現呆滯、磨牙，偏頭以及癱瘓等臨床症狀。住院接受mannitol及類固醇治療後症狀稍有改善，隨即進行電腦斷層掃瞄，判定為水腦。後續相同的內科治療無法更進一步改善神經症狀，且畜主拒絕外科引流手術並且出院返家。返家照顧及採取中醫針灸治療38天後，病情惡化，畜主因而要求安樂死並同意解剖。解剖結果除發現水腦症之病變外，更觀察到大腦灰質、部分腦膜及延腦中有大量淋巴球浸潤，且有围绕圍血管現象。免疫組織化學染色，發現大部分為CD3陽性的丁細胞以及少量的CD79a陽性B細胞。綜合檢驗及病理結果診斷為內水腦症(internal hydrocephalus)合併肉芽腫性腦膜腦炎(granulomatous meningoencephalomyelitis; GME)，推測患犬因合併罹患後者，致使水腦症惡化，預後不佳。

關鍵字

水腦症；肉芽腫性腦膜腦炎；狗

並列摘要

Internal hydrocephalus combined with granulomatous meningoencephalomyelitis is very uncommon and relatively difficult to diagnose before necropsy. A 2-year-old, about 2 kg body weight, male Maltese was presented at NTU animal hospital with clinical signs of dullness, teeth grinding, head tilt and paralysis. The patient was hospitalized and treated with mannitol and steroid. After mild improvement, computed tomography was performed and hydrocephalus was diagnosed. The following internal therapy could not improve neurological signs further but the owner refused surgical drainage. Euthanasia was performed because of the deterioration of clinical signs after discharge from hospital. Necropsy confirmed hydrocephalus and also observed a non-suppurative meningoencephalitis. Most of the lymphocytes were confirmed by immunohistochemistry stain (IHC) as CD3 positive T cells and small number of CD79a positive B cells. Internal hydrocephalus combined with granulomatous meningoencephalomyelitis were the definite diagnosis.

並列關鍵字

hydrocephalus ； granulomatous meningoencephalomyelitis ； dog

國際替代計量

病例報告：馬爾濟斯犬合併內水腦症及肉芽腫性腦膜腦炎一例

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