Immune Mediated Neutropenia
What is IMN?
Immune Mediated Neutropenia, or IMN, is when the body attacks the neutrophils a type of white blood cell. Neutrophils are responsible for fighting against infections. As you can imagine if you don’t have the white blood cells to fight off infections your body will catch any cold or infection that enters the system.
These pets are difficult to manage because the immune system needs to be suppressed to prevent killing of the neutrophils, but also support with antibiotics to kill the infections picked up.
It can seem very counterintuitive to give a patient with infections immune suppressing medication. In normal patients with an infection giving immune suppressants allows the infections to take over making the patient feel worse. In patients that are attacking their neutrophils, suppressing the immune system allows the body to keep the vital neutrophils and actually they feel better because they can start to fight off diseases.
Neutrophils take 4-6 days from the start of creation to be released into circulation and survive for a maximum of 2-3 days. This means that most neutrophils only survive 1-1.5 weeks.
IMN is an extremely rare disease. There was a retrospective study done in 2001 stating that of all the cases of neutropenic animals, less than 0.5% of these cases were immune mediated neutropenia.
These pets are difficult to manage because the immune system needs to be suppressed to prevent killing of the neutrophils, but also support with antibiotics to kill the infections picked up.
It can seem very counterintuitive to give a patient with infections immune suppressing medication. In normal patients with an infection giving immune suppressants allows the infections to take over making the patient feel worse. In patients that are attacking their neutrophils, suppressing the immune system allows the body to keep the vital neutrophils and actually they feel better because they can start to fight off diseases.
Neutrophils take 4-6 days from the start of creation to be released into circulation and survive for a maximum of 2-3 days. This means that most neutrophils only survive 1-1.5 weeks.
IMN is an extremely rare disease. There was a retrospective study done in 2001 stating that of all the cases of neutropenic animals, less than 0.5% of these cases were immune mediated neutropenia.
Who can get IMN?
Unfortunately IMN is extremely rare and there is not enough information to state what the predisposing factors are. That means until we get further information any pet could potentially get this disease.
There was a report from the World Small Animal Veterinary Association World Congress Proceedings in 2004 that stated there may be more pets with this disease going undiagnosed. If a veterinarian suspects this disease, it is highly recommended to work with a specialist to help diagnose it.
There was a report from the World Small Animal Veterinary Association World Congress Proceedings in 2004 that stated there may be more pets with this disease going undiagnosed. If a veterinarian suspects this disease, it is highly recommended to work with a specialist to help diagnose it.
What does an IMN patient look like?
IMN patients are sometimes difficult to identify as they look like any patient with an infection.
Because neutrophils are the first line of defense in fighting infections, patients diagnosed with IMN typically suffer from multiple infections that resolve with antibiotics. These pets respond immediately to antibiotics, but after finishing the course, quickly become sick again with the same disease or something else. They catch infections very easily and rapidly decline from seemingly normal ‘easy’ infectious agents.
They are susceptible to catching diseases a normal, healthy pet would not normally contract, or if it is a common disease, they become critically sick from it rapidly requiring intravenous antibiotics and hospitalization.
Unfortunately, in order to prevent these infections from occurring, the immune system must be suppressed to give the bone marrow a chance to create the neutrophils needed to mount a proper immune system response to infections. This seems counter-intuitive, but these pets will actually start to feel better when the immune system is suppressed.
Because neutrophils are the first line of defense in fighting infections, patients diagnosed with IMN typically suffer from multiple infections that resolve with antibiotics. These pets respond immediately to antibiotics, but after finishing the course, quickly become sick again with the same disease or something else. They catch infections very easily and rapidly decline from seemingly normal ‘easy’ infectious agents.
They are susceptible to catching diseases a normal, healthy pet would not normally contract, or if it is a common disease, they become critically sick from it rapidly requiring intravenous antibiotics and hospitalization.
Unfortunately, in order to prevent these infections from occurring, the immune system must be suppressed to give the bone marrow a chance to create the neutrophils needed to mount a proper immune system response to infections. This seems counter-intuitive, but these pets will actually start to feel better when the immune system is suppressed.
What happens after diagnosis?
Close monitoring of these patients CBC’s is key to maintaining proper numbers of neutrophils in circulation.
It is also important to monitor for any infections that may crop up. Speak to your veterinarian if you notice any unusual symptoms.
It is also important to monitor for any infections that may crop up. Speak to your veterinarian if you notice any unusual symptoms.
Treatment
We’ll discuss treatments in the ‘treatment’ section of this book since treatments for all of these immune mediated diseases are very similar.
For patients diagnosed with Immune Mediated Neutropenia because of the bodies inability to fight off infections there is a need to be treated appropriately with antibiotics and other supportive care. These treatments vary widely depending on what the patient is infected with.
For patients diagnosed with Immune Mediated Neutropenia because of the bodies inability to fight off infections there is a need to be treated appropriately with antibiotics and other supportive care. These treatments vary widely depending on what the patient is infected with.