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Concurrent chronic lymphocytic leukemia and primary hyperparathyroidism in a mule.
Abstract: A 26-year-old mule gelding was evaluated for chronic weight loss and decreased appetite. The mule had been losing weight and intermittently hypophagic for approximately 7 months. Laboratory analysis of whole blood and plasma identified severe total hypercalcemia, marked hypophosphatemia, markedly increased parathyroid hormone concentration, and marked lymphocytosis. A sestimibi scan intended to identify parathyroid gland tissue was nondiagnostic. Results of flow cytometry and PCR for antigen receptor rearrangement (PARR) were consistent with a B cell lymphoproliferative disorder, likely chronic lymphocytic leukemia (CLL). Although not previously described concurrently, these conditions may sometimes arise together, complicating definition of the underlying mechanism for weight loss and hypercalcemia in aged equids.
© 2023 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
Publication Date: 2023-04-28 PubMed ID: 37118906PubMed Central: PMC10229365DOI: 10.1111/jvim.16714Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
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Summary
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The study investigates the case of a 26-year-old mule suffering from both chronic weight loss and decreased appetite, diagnosed with concurrent chronic lymphocytic leukemia (CLL) and primary hyperparathyroidism. These conditions, although previously unheard of together, may mutually arise leading to complications in determining the cause of weight loss and hypercalcemia in aged horses.
Clinical Evaluation and Diagnosis
- The researchers investigated the causes of chronic weight loss and reduced appetite in a 26-year-old mule. These symptoms had been evident in the mule for about 7 months, raising concerns.
- Through laboratory analysis of the mule’s whole blood and plasma, several abnormalities were found. These included severe hypercalcemia, marked lymphocytosis, hypophosphatemia and a significant increase in the parathyroid hormone concentration.
- A sestimibi scan usually used to identify abnormalities in the parathyroid gland did not phase any positive results, leaving the causative conditions unclear at this stage.
Diagnosis Confirmation and Rarity of Condition
- The researchers conducted flow cytometry and PCR for antigen receptor rearrangement (PARR) to probe deeper into the condition. These tests were suggestive of a B cell lymphoproliferative disorder, likely CLL.
- The presence of both CLL and primary hyperparathyroidism in the mule is an unusual case. There aren’t previous descriptions of these conditions arising concurrently.
Implication for Aged Equids
- This study suggests that aged equids, like the mule under observation, could suffer from both CLL and primary hyperparathyroidism concurrently.
- These conditions could complicate the understanding of the exact causes of symptoms such as weight loss and hypercalcemia.
Cite This Article
APA
Townsend KS, Johnson PJ, Donnelly LL, LaCarrubba AM, Lattimer JC, Havis B, Springer NL, Kim DY.
(2023).
Concurrent chronic lymphocytic leukemia and primary hyperparathyroidism in a mule.
J Vet Intern Med, 37(3), 1250-1255.
https://doi.org/10.1111/jvim.16714 Publication
Researcher Affiliations
- Department of Veterinary Medicine and Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA.
- Department of Veterinary Medicine and Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA.
- Department of Veterinary Medicine and Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA.
- Department of Veterinary Medicine and Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA.
- Department of Veterinary Medicine and Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA.
- Department of Veterinary Medicine and Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA.
- Department of Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, Tennessee, USA.
- Department of Veterinary Medicine and Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA.
MeSH Terms
- Male
- Horses
- Animals
- Leukemia, Lymphocytic, Chronic, B-Cell / complications
- Leukemia, Lymphocytic, Chronic, B-Cell / diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell / veterinary
- Equidae
- Hypercalcemia / diagnosis
- Hypercalcemia / veterinary
- Hyperparathyroidism, Primary / diagnosis
- Hyperparathyroidism, Primary / veterinary
- Lymphocytosis / veterinary
- Horse Diseases / diagnosis
Conflict of Interest Statement
Authors declare no conflict of interest.
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