著者
Mai INOUE Katsuaki SUGIURA
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
pp.21-0171, (Released:2021-05-17)
被引用文献数
2

This study aimed to identify the causes of death in dogs that were buried at pet cemeteries. Using data obtained from a questionnaire completed by 5,118 dog owners from 1 April 2016 to 31 March 2017, we estimated the life expectancy and the odds ratio for principal causes of death using multiple logistic regression analysis with potential risk factors as independent variables. The life expectancy determined at birth was 13.98 years. The commonest cause of death was senility. The odds ratios of dying of senility being significantly higher in Labrador Retrievers and Shiba breeds and aged dogs, and significantly lower in Chihuahuas, dogs living indoors and neutered dogs.
著者
Sayaka TSUCHIDA Takanari HATTORI Akiko SAWADA Koretsugu OGATA Jun WATANABE Kazunari USHIDA
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
pp.21-0076, (Released:2021-05-03)
被引用文献数
2

We performed a comprehensive fecal metabolite analysis using LC-MS/MS and LC-QTOF-MS approaches as a preliminary study. Feces of Japanese macaques on Yakushima Island were collected from five monkeys at two separate locations. Using the former methodology, 59 substances such as free amino acids, nucleotides, nucleosides and nucleic acid bases, and organic acids in the citrate cycle were quantitatively detected and successfully differentiated in two different monkey groups by the concentrations of nucleic acid metabolites and free amino acids. In the latter, around 12,000 substances were detected both by positive and negative mode in each sample. Differences in signal intensities were observed between two monkey groups in the concentrations of plant secondary metabolites such as cyanogenic glycosides, flavonoids, and phenolics.
著者
Hiroshi OHTA Noriyuki NAGATA Nozomu YOKOYAMA Tatsuyuki OSUGA Noboru SASAKI Keitaro MORISHITA Mitsuyoshi TAKIGUCHI
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
vol.83, no.3, pp.378-384, 2021 (Released:2021-03-11)
参考文献数
20
被引用文献数
1

To date, little is known about the prognostic significance of ultrasonographic findings in dogs with protein-losing enteropathy (PLE). The aim of this retrospective study was to examine the prognostic value of ultrasonographic findings in dogs with PLE. A total of 26 dogs with PLE were included: 20 dogs with chronic enteropathy and 6 dogs with gastrointestinal lymphoma. The presence of small intestinal dilatation was associated with shorter survival time in dogs with PLE (P=0.003). The presence of hyperechoic intestinal mucosal striations was associated with longer survival time in dogs with PLE (P=0.0085). The results of the current study indicate that the presence of small intestinal dilatation might be associated with poor prognosis in dogs with PLE.
著者
Maho NAKAZAWA Hirotaka TOMIYASU Kanako SUZUKI Hajime ASADA Aki FUJIWARA-IGARASHI Yuko GOTO-KOSHINO Aki OHMI Koichi OHNO Michio FUJITA Hajime TSUJIMOTO
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
vol.83, no.3, pp.456-460, 2021 (Released:2021-04-03)
参考文献数
20
被引用文献数
6

Nasal lymphoma (NL) is the most common nasal tumor in cats, and radiotherapy, chemotherapy, or a combination of these treatments have been described as the treatment for this disease. However, the previous studies included various machines and protocols of radiotherapy. Therefore, we aimed to retrospectively compare the prognosis among cases treated with palliative hypofractionated radiotherapy, chemotherapy, and a combination of them with united machine and protocol of radiotherapy. When compared overall survival and progression free survival, there was no significant difference among these three groups. The data of this study suggested that similar efficacy could be achieved by palliative hypofractionated radiotherapy, chemotherapy, or a combination of them.
著者
Yuki IWATA Hirotaka KONDO Iori KOIZUMI Hisashi SHIBUYA
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
pp.21-0145, (Released:2021-04-28)
被引用文献数
2

An 8-year-and-1-month-old female blue tegu (Salvator merianae) was brought to a clinician with severe cough. The patient died 11 days later despite supportive care, and necropsy was performed by a clinician. The lumen of the distal trachea was almost completely occluded by a milk-white, hard mass measuring 1 cm in diameter. Histopathologically, the mass comprised spindle-shaped to polygonal cells arranged in a loose sheet with abundant production of basophilic cartilaginous matrix, consistent with chondrosarcoma. Reports of tracheal neoplasms in reptiles are limited, and to the best of our knowledge this represents the first pathological documentation of tracheal chondrosarcoma in a reptile.
著者
Koji SUGITA Ayaka SHIMA Kaho TAKAHASHI Yasuyoshi MATSUDA Masaki MIYAJIMA Marin HIROKAWA Hirotaka KONDO Junpei KIMURA Genki ISHIHARA Keitaro OHMORI
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
pp.21-0063, (Released:2021-04-26)
被引用文献数
10

A 7-year 6-month-old, castrated male Shiba dog presented with a 1-month history of lethargy, anorexia, vomiting, and frequent watery diarrhea. Weight loss, hypoalbuminemia, anemia, and leukocytosis were detected at the first visit. The dog was diagnosed with non-responsive enteropathy (NRE) based on clinical and histopathological examinations. Since the dog did not respond to the immunosuppressive drugs, fecal microbiota transplantation (FMT) was performed during the treatment with chlorambucil. A single endoscopic FMT into the cecum and colon drastically recovered clinical signs and clinicopathological abnormalities and corrected dysbiosis in the dog. No recurrence or adverse events were observed. The present case report suggests that FMT, possibly together with chlorambucil, might be a treatment option for NRE in Shiba dogs that have poorer prognosis compared with other dog breeds.
著者
Susumu IWAIDE Naoki UJIKE Kyoko KOBAYASHI Yukiko SASSA Tomoaki MURAKAMI
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
pp.20-0713, (Released:2021-04-28)
被引用文献数
2

In AA amyloidosis, cross-species oral transmission has been demonstrated in several animal models. While it is known that the transmission efficiency of AA amyloidosis between different species is lower than that among the same species, the mechanism of this species-barrier is unclear. In this study, we found at first that mice orally given a large amount of bovine AA simultaneously with inflammatory stimulation did not develop AA amyloidosis. Therefore, we hypothesized that the low efficiency of the cross-species oral transmission of AA amyloidosis might be due to the low absorption rate in Peyer's patches. To evaluate the hypothesis, we next investigated whether bovine AA was taken up by Peyer's patches and translocated to other organs in vivo and ex vivo models. The direct absorption of bovine AA by Peyer’s patches was not observed. Besides, translocation of bovine AA to the mesenteric lymph nodes, spleen, liver, or kidney was not observed except the mesenteric lymph node of a single mouse. Thus, absorption of bovine AA by Peyer's patches occurred much less efficiently in mouse models of cross-species oral transmission of AA amyloidosis. The present study suggests that the less efficient amyloid uptake by Peyer’s patches may be involved in the species-barrier of oral transmission of AA amyloidosis.
著者
Hiroto KOBAYASHI Susumu IWAIDE Naoki UJIKE Tomoaki MURAKAMI
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
pp.21-0022, (Released:2021-04-20)
被引用文献数
1

Amyloid A (AA) amyloidosis is a lethal disease characterized by systemic AA amyloid deposition, and it reported in many animal species. Despite experiments have shown that AA amyloidosis can be transmitted orally, horizontal transmission and cross-species transmission are concerns, the transmission mechanism has been unknown. In this study, we examined the oral transmission efficiency of AA amyloidosis using oxazolone-induced gastrointestinal disorder mice. As a result, the upper or lower gastrointestinal disorder groups developed more severe amyloid deposition in systemic tissues than the group without gastrointestinal disorders. The results of this study suggest that gastrointestinal damage promotes the oral transmission of AA amyloidosis.
著者
Kanae NIIMI Motoko MORIMOTO
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
vol.83, no.4, pp.573-580, 2021 (Released:2021-04-09)
参考文献数
25
被引用文献数
3

To eliminate pathogens, the initiation of an appropriate immune response is critical. When the gastrointestinal nematode, Heligmosomoides polygyrus (Hp), invades the small intestine, a type-2 cytokine response is initiated; however, this response is not sufficient to clear the infection, and chronic infection can ensue. In this study, the host defense against Hp was investigated in mice with a focus on the role of CD4+ T cells. To this end, tissues from the small intestine and mesenteric lymph node (MLN) were collected every day from just after infection until Day 5 because many previous studies have described the later stages of infection from Day 8 to Day 12, during which Hp returns to the lumen and Th2 cytokine expression reaches its peak. In this study, we focused on investigating the initiation of the type-2 immune response. Our results indicated that the larvae encysted by Day 3. Increased type-2 cytokine gene expression started in the small intestine before Day 2 and increased again on Day 5. Interferon (IFN) γ increased significantly on the second day. Flow cytometry and gene expression analysis of MLN cells revealed that CD4+ T cells were not activated until Day 4. These results suggested that innate immune cells in submucosa are activated immediately after infection, but CD4+ T cells accumulate in the cyst zone later. In addition, IFNγ may have an important role in converting type-2 cytokine-producing cells from innate cells to CD4+ T cells.
著者
Munekazu NAKAICHI Toshie ISERI Hiro HORIKIRIZONO Misa KOMINE Harumichi ITOH Hiroshi SUNAHARA Yuki NEMOTO Kazuhito ITAMOTO Kenji TANI
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
pp.21-0061, (Released:2021-04-09)
被引用文献数
3

A male 25-month-old Dalmatian dog attended our veterinary hospital because of anorexia and high circulating liver enzyme activities. Abdominal computed tomography showed a slightly small liver with rounded edges, and laparoscopic examination showed that the liver was yellowish. Histopathological examination revealed multifocal necrosis of hepatocytes and severe chronic hepatitis. Rhodanine staining showed severe copper accumulation in hepatocytes and a quantitative analysis of the copper content of the liver showed substantial accumulation (10.3 mg/g dry mass), suggesting a diagnosis of copper-associated hepatitis. Previously reported canine mutation in the COMMD1, the gene responsible for the copper-associated hepatitis in the Bedlington terrier, was not identified. To our knowledge, this is the first report of copper-associated hepatitis in a Dalmatian in Japan.
著者
Fumi MATSUMOTO Mariko SHIMA-SAWA Yu FURUSAWA Osamu YAMATO Akira YABUKI
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
pp.20-0597, (Released:2021-04-05)

CD20 and CD3 are considered reliable markers for B and T cells, respectively. This study aimed to develop a rapid multiple immunofluorescence (RMIF) method for the detection of CD20 and CD3 on a single cytology slide. Air-dried smears were prepared using samples collected from dogs (n=26) and cats (n=6). Immunosignal detection using the newly developed method required 60 min. Clear immunosignals for CD20 and CD3 were detected in 24 of 26 samples in dogs and in all 6 cats. As the RMIF (CD20/CD3) method can detect markers of both B and T cells simultaneously on a single cytology smear, it would be an efficient tool for the immunophenotyping of canine and feline lymphoma samples.
著者
Akira YABUKI Yu FURUSAWA Noriaki MIYOSHI Kazuyuki TANIGUCHI Osamu YAMATO
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
pp.21-0074, (Released:2021-04-05)

Renin and neuronal nitric oxide synthase in the kidney control the renin-angiotensin and tubuloglomerular feedback systems. The present study investigated the expression of renin and neuronal nitric oxide synthase in the dysplastic kidneys of three young dogs. Renin-immunoreactivity, which occurs in the juxtaglomerular and tubular cells of dysplastic kidneys, did not differ from that in the normal kidneys of young dogs. Macula densa cells in the normal kidneys showed neuronal nitric oxide synthase -immunoreactivity, but those in the dysplastic kidneys showed no apparent signals. This observation may be correlated with the pathological mechanisms of renal failure in young dogs.
著者
Celina Emiko OKAMOTO-OKUBO Renata Navarro CASSU Jean Guilherme JOAQUIM Luciane Dos Reis MESQUITA Sheila Canevese RAHAL Hugo S Salvador OLIVEIRA Regina TAKAHIRA Isadora ARRUDA Leandro MAIA Fernanda Da Cruz LANDIM Stelio Pacca Loureiro LUNA
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
pp.20-0730, (Released:2021-04-05)
被引用文献数
13

This prospective, comparative, randomized, horizontal, and double-blind clinical study investigated the clinical efficacy of leucocyte-poor platelet-rich plasma (PRP, n=8) or allogeneic adipose-derived stem cells (ADSC, n=8) in dogs with bilateral degenerative hip joint disease (DHJD). Sixteen dogs were treated with two intra-articular injections of PRP or ADSCs, within a 30-day interval. The Canine Brief Pain Inventory (CBPI), the Helsinki Chronic Pain Index (HCPI), and Visual Analogue Scales for pain (VAS-pain) and locomotion (VAS-loc) were assessed by the dog owners. Analysis-of-gait using a force plate, response to palpation (VAS-palp), and the descriptive numerical scale for pain (DNS) were measured by a veterinarian. The assessments were performed before (baseline), 30 and 60 days after the first treatment. Data were analyzed using the unpaired-t test, paired Wilcoxon test, Fisher´s exact test, and Mann-Whitney and Friedman tests (P<0.05). Compared with baseline HCPI, CBPI, VAS-pain, and VAS-palp scores reduced 41%, 52%, 51%, and 48% (P=0.0001–0.03) at 60 days in the ADSC group. In PRP-treated dogs, CBPI, VAS-loc, and DNS scores decreased by 43%, 43%, and 33% at 60 days, respectively (P=0.0003–0.011). Based on CBPI data, the rate of success at 60 days was 75% and 25% in the ADSC and PRP groups (P=0.13), respectively. Both therapies were apparently safe and effective to reduce chronic pain in dogs with bilateral DHJD during a 60-day period. However, a trend towards greater improvement was provided by the ADSC treatment.
著者
Hyunkyoung LEE Hyeshin HWANG Younghye RO Ji-Hyeon KIM Kyunghyun LEE Eunjin CHOI Youchan BAE Byungjae SO Inhyung LEE
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
pp.20-0741, (Released:2021-03-29)
被引用文献数
7

This study was performed to examine and clarify the cause of hindlimb ataxia and neuropathy seen in the South Korean horse population. Fifty horses diagnosed with hindlimb ataxia and neuropathy were referred for this study. Neurological examination was performed on 47 horses while necropsy was performed in all 50 animals. The occurrence of neurological diseases increased rapidly in the summer and 47 out of 50 horses were referred after the end of July. The incidence of neurological diseases started from the southern part of Korea in July and proceeded northward in August and September. Although there was no correlation with age, Thoroughbred and Warmblood horses showed a higher incidence rate than Halla and Jeju horses. The incidence rate was 5 times higher in geldings than in mares and stallions. Of the 20 cases, 16 were diagnosed with eosinophilic meningoencephalomyelitis in 2015. The most common lesions observed in 2016 were parasitic meningoencephalomyelitis (10 cases, 33%) and eosinophilic meningomyelitis (7 cases, 23%). Histopathological analysis of the brain and spinal cord revealed nematodes of approximately 100–200 μm in diameter, microcavitation and infiltrates of eosinophils, and brown pigmented macrophage infiltrates. The nematodes were identified as Setaria digitata via DNA sequencing, performed subsequent to polymerase chain reaction using DNA isolated from formalin-fixed paraffin-embedded tissue sections of the spinal cord. These results show that aberrant migration of Setaria digitata larva in the brain and spinal cord was a major cause for neurological signs in horses.
著者
Yoshinori TAKAMI Hitoshi KOIEYAMA Nobuo SASAKI Takumi IWAI Youki TAKAKI Takehiro WATANABE Yasutugu MIWA
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
pp.20-0315, (Released:2021-01-21)

Urolithiasis is a disease often seen in tortoises at veterinary hospitals, however there have been no comprehensive research reports of tortoises with urolithiasis in Japan. In this study, we analyzed tortoises diagnosed with urolithiasis at three domestic veterinary hospitals. Based on medical records, we assessed the diagnostic method, species, sex, body weight, dietary history, husbandry, clinical signs, clinical examination, treatment for urolithiasis, and clinical outcome. The total number of cases in the 3 facilities was 101. As for species of tortoises, the most common was the African spurred tortoise (Centrochelys sulcata) with 42 cases (41.6%), followed by the Indian star tortoise (Geochelone elegans) with 30 cases (29.7%). Six other species were confirmed to have calculi. Almost all cases (99 cases, 98%) had a single calculus, and only 2 had multiple calculi. The prevalence of urolithiasis for the total number of tortoises having visited to one institution during the same period was 5.1%. Of the 86 cases that underwent calculi removal, 64 (74.4%) were successfully removed via the vent, and the efficacy of this method was confirmed. Nineteen cases (22%) were approached via plastronotomy, among which only 2 died postoperatively. In this study, we could not clarify the relationship between calculi formation and diets or other husbandry factors.
著者
Yingxin ZHANG Zhixuan ZHANG Yinying LOU Yonglan YU
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
pp.20-0681, (Released:2021-03-18)
被引用文献数
10

A year-round molecular epidemiological survey (2017 to 2018) was conducted on three hemoplasmas and two Bartonella species with zoonotic potential in client-owned cats in Beijing and Shanghai. Among 668 specimens, the overall hemoplasma-positive rate was 4.9% (3.4% for Candidatus Mycoplasma haemominutum, 0.9% for Mycoplasma haemofelis and 1.2% for Candidatus Mycoplasma turicensis). The overall Bartonella-positive rate was 8.5% (4.8% for B. henselae and 4.3% for B. clarridgeiae). Age, breed, ectoparasiticide use and stray history, but not city, season and gender, were significantly associated with the positive rates of one or more pathogens. This is also the first report on the prevalence of Candidatus Mycoplasma turicensis in cats in China.
著者
Manabu KOIKE Yasutomo YUTOKU Aki KOIKE
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
pp.20-0679, (Released:2021-03-17)
被引用文献数
5

Radioresistance and radiotoxicity have been reported following cancer treatments in felines. Optimizing radiation doses to induce cytotoxic effects to only cancer cells and not normal cells is critical in achieving effective radiation therapy; however, the mechanisms of radiation resistance, radiotoxicity, and DNA damage response (DDR) in feline cells have not yet been elucidated. A DNA double-strand break (DSB) is the most toxic type of DNA damage induced by X-rays and heavy ion beams used in treating cancers. Crandell-Rees Feline Kidney (CRFK) cells is one of the most widely used cat cells in life science research. Here, we report that DSB-triggered senescence induced by X-rays is important in inhibiting the proliferation of CRFK cells. We demonstrated through cell proliferation assay that X-rays at doses 2 Gy and 10 Gy are toxic to CRFK cells that irradiating CRFK cells inhibits their proliferation. In X-irradiated CRFK cells, a dose-dependent increase in DSB-triggered senescence was detected according to morphological changes and using senescence-associated β galactosidase staining assay. Moreover, our data indicated that in CRFK cells, the major DDR pathway, which involves the phosphorylation of H2AX at Ser139, was normally activated by ATM kinases. Our findings are useful in the understanding of X-rays-induced cellular senescence and in elucidating biological effects of radiation, e.g., toxicity, in feline cells. Furthermore, our findings suggest that the CRFK cell line is an excellent matrix for elucidating radioresistance and radiotoxicity in cat cells.
著者
Aritada YOSHIMURA Takahiro OHMORI Kokoro ITOU Ryo ISHI Yuri MATSUMURA Yuhei WADA Miori KISHIMOTO Tomoko IWANAGA Naoki MIURA Kazuhiko SUZUKI Ryuji FUKUSHIMA
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
pp.20-0409, (Released:2021-03-15)
被引用文献数
2

In dogs, pancreatic acinar cell injury is thought to be caused by decreased pancreatic blood flow due to heart failure. In previous our report, it demonstrated that decreased heart function causes a significant decrease in pancreatic blood flow in heart failure dog model caused by rapid ventricular pacing (RVP). However, the types of histopathological changes remain unclear. We aimed to verify the types of histopathological changes occurring in the pancreatic tissue due to decreased heart function. After RVP for 4 weeks, atrophy of pancreatic acinar cells, characterized by a decrease in zymogen granules, was observed in all areas of the pancreas. In conclusion, the result of this study suggests that attention should be paid to ischemia/hypoperfusion injury in the pancreas.
著者
Tomomi TAKANO Haruna WATANABE Tomoyoshi DOKI Hajime KUSUHARA
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
pp.20-0703, (Released:2021-03-11)
被引用文献数
1

Feline noroviruses (FNoVs) are potential clinical pathogens in cats. To perform an epidemiological study of FNoV infection, it is necessary to develop a simple and effective method for virus detection. We investigated whether a commercial human NoV quantitative RT-PCR kit for the detection of human NoVs used in medical practice can be applied for FNoV detection. This kit was capable of detecting the FNoV gene regardless of the genogroup (GIV and GVI) in experimental and field samples. Based on the above findings, it is possible to detect FNoVs using human NoV tests. The relationship between FNoV infection and gastroenteritis in cats may be clarified by applying these methods to an epidemiological survey of FNoVs.
著者
Makoto AKIYOSHI Masaharu HISASUE Sakurako NEO Masami AKIYOSHI
出版者
JAPANESE SOCIETY OF VETERINARY SCIENCE
雑誌
Journal of Veterinary Medical Science (ISSN:09167250)
巻号頁・発行日
pp.20-0566, (Released:2021-03-11)
被引用文献数
1

This report describes the cases of two Miniature Dachshunds who were suspected to have immune-mediated hemolytic anemia (IMHA) and were treated with immunosuppressive therapy. However, progression of anemia, increases in C-reactive protein (CRP) and total-bilirubin (T-Bil) levels, splenomegaly, transition to nonregenerative anemia, and thrombocytopenia occurred after the treatment. Splenectomy and bone-marrow aspirations were performed subsequently. Both dogs were diagnosed with hemophagocytic syndrome (HPS) associated with IMHA. Unfortunately, they died 9 and 6 days later. These findings indicate that some cases of refractory IMHA have the pathogenicity of HPS. HPS should be included as a differential diagnosis of refractory IMHA concurrent with thrombocytopenia. Continuously elevated CRP and T-Bil levels may be helpful indicators in the detection of HPS associated with IMHA.