ABSTRACT
BACKGROUND: The cause of gallbladder mucocele (GBM) formation in dogs currently is unknown. Many available drugs represent a newer generation of xenobiotics that may predispose dogs to GBM formation. OBJECTIVE: To determine if there is an association between the histologic diagnosis of GBM in dogs and administration of selected drugs. ANIMALS: Eighty-one dogs with a histologic diagnosis of GBM and 162 breed, age, and admission date-matched control dogs from a single referral institution. METHODS: Medical records of dogs with GBM and control dogs from 2001 to 2011 were reviewed. Owner verification of drug history was sought by a standard questionnaire. Reported use of heartworm, flea, and tick preventatives as well as nonsteroidal anti-inflammatory drugs, analgesics, corticosteroids, or medications for treatment of osteoarthritis was recorded. RESULTS: Dogs with GBM were 2.2 times as likely to have had reported use of thyroxine (as a proxy for the diagnosis of hypothyroidism) as control dogs (95% confidence interval [CI], 0.949-5.051), 3.6 times as likely to have had reported treatment for Cushing's disease (95% CI, 1.228-10.612), and 2.3 times as likely to have had reported use of products containing imidacloprid (95% CI, 1.094-4.723). Analysis of a data subset containing only Shetland sheepdogs (23 GBM and 46 control) indicated that Shetland sheepdogs with GBM formation were 9.3 times as likely to have had reported use of imidacloprid as were control Shetland sheepdogs (95% CI, 1.103-78.239). CONCLUSIONS AND CLINICAL IMPORTANCE: This study provides evidence for an association between selected drug use and GBM formation in dogs. A larger epidemiologic study of Shetland sheepdogs with GBM formation and exposure to imidacloprid is warranted.
Subject(s)
Dog Diseases/chemically induced , Gallbladder Diseases/veterinary , Imidazoles/adverse effects , Mucocele/veterinary , Nitro Compounds/adverse effects , Thyroxine/adverse effects , Animals , Case-Control Studies , Cholinergic Agents/adverse effects , Dogs , Female , Gallbladder Diseases/chemically induced , Hypothyroidism/drug therapy , Male , Mucocele/chemically induced , Mucocele/pathology , Neonicotinoids , Pituitary ACTH Hypersecretion/drug therapy , Pituitary ACTH Hypersecretion/veterinary , Risk FactorsABSTRACT
We describe a 55-year-old bisexual Belgian man with a multi-drug resistant HIV infection who developed an Immune Reconstitution Inflammatory Syndrome (IRIS) presenting as a mucocele of the frontal sinus, one year after starting a new effective darunavir containing antiretroviral treatment regimen. His CD4+ lymphocyte count had increased from 3 cells/mm3 prior to the start of the latter treatment to 196 cells/mm3 just before he developed the IRIS phenomenon. IRIS is a paradoxical clinical deterioration during highly active antiretroviral treatment (HAART), due to an exaggerated immune-inflammatory reaction. With the increasing numbers of persons living with HIV infection and the increased use of HAART it is expected that in the future more otolaryngological manifestations of IRIS will be detected.
Subject(s)
Antiretroviral Therapy, Highly Active/adverse effects , HIV Infections/drug therapy , Immune Reconstitution Inflammatory Syndrome/chemically induced , Mucocele/chemically induced , Paranasal Sinus Diseases/chemically induced , CD4 Lymphocyte Count , Humans , Immune Reconstitution Inflammatory Syndrome/diagnosis , Immune Reconstitution Inflammatory Syndrome/immunology , Magnetic Resonance Imaging , Male , Middle Aged , Mucocele/diagnosis , Mucocele/immunology , Paranasal Sinus Diseases/diagnosis , Paranasal Sinus Diseases/immunologyABSTRACT
Superficial mucoceles are small, clear vesicles that occur on clinically non-inflamed mucosa and are often misdiagnosed as vesiculobullous disorders. Soft palate, retromolar pads, and posterior buccal mucosa are common sites of involvement. The lesions are more common in women than in men and need no treatment. This paper describes a 71-year-old female who demonstrated some of the pitfalls in diagnosis and a possible contributory role of a tartar-control toothpaste in the onset of the lesions.
