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Home / Equine Research Bank / Equine Vet J / Immune-mediated haemolytic anaemia and thrombocytopenia in 2...
Equine veterinary journal2020; 53(5); 964-971; doi: 10.1111/evj.13384

Immune-mediated haemolytic anaemia and thrombocytopenia in 25 adult equids: 1997-2016.

Abstract: Information concerning clinical presentation, conditions associated with immune-mediated haemolytic anaemia (IMHA) and thrombocytopenia (IMTP) and outcome in equids is lacking. Previous case reports suggest that immune-mediated disease and neoplasia are associated. Objective: Characterise the clinical presentation, clinicopathologic data, underlying conditions, treatment and outcome of IMHA and IMTP cases in equids. We hypothesise that IMHA with concurrent thrombocytopenia occurs more often than IMHA or IMTP alone, and that neoplasia is commonly associated with these immune diseases and cases frequently have a poor prognosis. Methods: Retrospective case-control study. Methods: Medical records were reviewed from 1997 to 2016. Twenty-five equids were diagnosed with IMHA, IMTP or IMHA with thrombocytopenia by Coombs test or flow cytometry. Controls were equids presented for nonimmune-mediated disease immediately prior to and after study animals. Fisher's exact test was used to compare between groups for categorical variables (P < .05). Results reported as odds ratios (OR) and 95% confidence intervals (CI). Unpaired t test and Mann-Whitney test were used to compare between groups for continuous variables (P < .05). Results: Neoplasia incidence was significantly higher in the study population (28%) versus controls (8%) (P = .04). Equids with primary disease were more likely to survive to discharge than equids with secondary disease (8/9 vs 7/16; P = .03; OR = 13.3; 95% CI: 1.3-134.7). Survivors had a significantly lower blood urea nitrogen (BUN) than those that died or were subjected to euthanasia (survivors, 6.1 ± 2.5 mmol/L vs nonsurvivors, 9.9 ± 3.1 mmol/L P = .003). The odds of short-term mortality were higher in horses presenting with increased BUN (OR = 19.5; 95% CI, 1.8-214.1; P = .009). Conclusions: Retrospective nature of the study, small case numbers and limited long-term follow-up. Conclusions: Primary IMHA/IMTP cases have a reasonable prognosis and warrant treatment. Secondary cases have a poor prognosis, and are frequently associated with cancer. BUN may have utility as a prognostic indicator for IMHA/IMTP cases.
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Publication Date: 2020-12-03 PubMed ID: 33169417DOI: 10.1111/evj.13384Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research studies the clinical presentation, associated conditions, and outcomes of immune-mediated haemolytic anaemia (IMHA) and thrombocytopenia (IMTP) in horses. The study suggests that these immune conditions frequently occur along with cancer, and indicate a poor prognosis.

Research Objectives and Methodology

  • The aim of the study was to understand the clinical presentation, the conditions associated with IMHA and IMTP in horses, and the outcomes of these conditions.
  • The researchers hypothesized that IMHA with concurrent thrombocytopenia is more common than IMHA or IMTP occurring separately, and that cancer often accompanies these immune conditions, leading to a poor prognosis.
  • The study utilized a retrospective case-control design. Medical data of 25 horses diagnosed with either IMHA, IMTP, or both from 1997 to 2016 was analysed.
  • The study group was compared to a control group consisting of horses which presented for nonimmune-mediated diseases before and after the study cases.
  • The comparison between groups for categorical variables were performed using Fisher’s exact test while the unpaired t-test and Mann-Whitney test were used for continuous variables.

Research Findings

  • The study found that the incidence of cancer was significantly higher in the study group (28%) than the controls (8%).
  • The outcome for horses with primary disease was better than horses with secondary diseases. The odds of survival till discharge were 13.3 times higher in horses with primary diseases as compared to those with secondary diseases.
  • A significant finding of the research was the level of blood urea nitrogen (BUN) in survivors and non-survivors. Non-survivors had a higher BUN than survivors, suggesting that an increased BUN level was associated with a higher likelihood of short-term mortality.

Conclusions and Limitations

  • The study concludes that horses with primary IMHA/IMTP have a reasonable prognosis and should be treated. However, secondary cases, particularly those associated with cancer have a poor prognosis.
  • The level of BUN can serve as a prognostic tool for IMHA/IMTP cases.
  • The study acknowledges its limitations including the retrospective nature, small sample size, and limited long-term follow-up information.

Cite This Article

APA
Easton-Jones CA, Estell KE, Magdesian KG. (2020). Immune-mediated haemolytic anaemia and thrombocytopenia in 25 adult equids: 1997-2016. Equine Vet J, 53(5), 964-971. https://doi.org/10.1111/evj.13384

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 53
Issue: 5
Pages: 964-971

Researcher Affiliations

Easton-Jones, Charlotte A
  • Rossdales LLP, Exning, Newmarket, Suffolk, UK.
Estell, Krista E
  • Virginia Tech Marion duPont Scott Equine Medical Center - Internal Medicine, Leesburg, Virginia, USA.
Magdesian, K Gary
  • Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA.

MeSH Terms

  • Anemia, Hemolytic, Autoimmune / veterinary
  • Animals
  • Case-Control Studies
  • Horse Diseases / etiology
  • Horses
  • Retrospective Studies
  • Thrombocytopenia / etiology
  • Thrombocytopenia / veterinary

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Citations

This article has been cited 1 times.
  1. Drozdzewska K, Gehlen H. Markers for internal neoplasia in the horse. Vet Med Sci 2023 Jan;9(1):132-143.
    doi: 10.1002/vms3.1042pubmed: 36495211google scholar: lookup
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