Multiple myeloma presenting as blepharitis in a horse.
Abstract: Myeloma-related disorders, including multiple myeloma, extramedullary plasmacytoma, and solid osseous plasmacytoma, are rare in horses. Clinical complaints for myeloma-related disorders are nonspecific, and when present, M-protein location is more variable on protein electrophoresis in horses relative to dogs and cats. Here, we describe a case of a 15-year-old Thoroughbred mare who presented with recurrent blepharitis. Marked hyperglobulinemia was an incidental finding on routine hematologic and biochemical testing. Bone marrow aspiration consisted of >30% plasma cells, and serum protein electrophoresis demonstrated a monoclonal gammopathy in the alpha 2 fraction leading to a diagnosis of multiple myeloma. Immunofixation and radial immunodiffusion confirmed the presence of an IgG M-protein. Based on a restricted peak in the alpha 2 location, the specific M-protein is suspected to be IgG(T), an IgG isotype unique to horses. M-protein migration in horses is variable relative to dogs and cats, yet immunofixation can still be used to identify equine IgG M-protein isotypes. The unique clinical presentation in this case also serves as a reminder to consider neoplasia in horses with unusual or nonspecific clinical signs.
© 2023 American Society for Veterinary Clinical Pathology.
Publication Date: 2023-05-29 PubMed ID: 37248209DOI: 10.1111/vcp.13227Google Scholar: Lookup
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Summary
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This research article details a rare case of multiple myeloma, a type of cancer, found in a 15-year-old Thoroughbred mare that was manifesting as blepharitis, an eyelid inflammation condition. Routine tests and specific diagnostics confirmed the presence of this typically human disease in the horse, emphasizing the need for considering such uncommon illnesses in animals exhibiting unusual symptoms.
Myeloma-Related Disorders in Horses
- The research highlights that myeloma-related disorders, which encompass multiple myeloma, extramedullary plasmacytoma, and solid osseous plasmacytoma, are quite rare in horses.
- These disorders often present with nonspecific symptoms and signs, making them hard to diagnose.
- Additionally, horses exhibit more variations in M-protein location on protein electrophoresis compared to dogs and cats, further complicating the diagnostic process.
Present Case Overview
- The 15-year-old Thoroughbred mare was initially observed with recurrent blepharitis, an inflammation of the eyelids.
- Marked hyperglobulinemia, an excess of globulins in the blood, was detected in routine hematologic and biochemical tests. This finding led to further diagnostic investigations.
- A bone marrow aspiration revealed that more than 30% of the marrow comprised plasma cells, an unusually high proportion.
- Additional testing via serum protein electrophoresis exhibited a monoclonal gammopathy in the alpha 2 fraction, finally leading to a diagnosis of multiple myeloma.
Definitive Diagnostics and M-Protein Identification
- Immunofixation and radial immunodiffusion, specific diagnostic tests, confirmed the presence of an IgG M-protein, a protein hallmark of this cancer.
- Given the M-protein’s location, it is suspected to be IgG(T), an IgG isotype that is unique to horses.
- Despite the variety in M-protein migration in horses when compared to other animals like dogs and cats, immunofixation can still effectively identify equine IgG M-protein isotypes.
Significance of the Study
- This research underlines the importance of considering atypical or rare diseases like neoplasia in horses when they display unusual or nonspecific clinical signs.
- The findings enrich the scarce data on myeloma-related disorders in horses, enhancing the understanding of these diseases for better diagnostic and treatment strategies in the future.
Cite This Article
APA
Hayes AM, Kastl B, Perry E, Moore AR, Springer NL.
(2023).
Multiple myeloma presenting as blepharitis in a horse.
Vet Clin Pathol, 52(3), 514-520.
https://doi.org/10.1111/vcp.13227 Publication
Researcher Affiliations
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, Kansas, USA.
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, Kansas, USA.
- Humphrey Giacopuzzi Equine Hospital, Somis, California, USA.
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USA.
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, Kansas, USA.
MeSH Terms
- Horses
- Animals
- Female
- Cats
- Dogs
- Multiple Myeloma / complications
- Multiple Myeloma / diagnosis
- Multiple Myeloma / veterinary
- Plasmacytoma / diagnosis
- Plasmacytoma / veterinary
- Cat Diseases
- Dog Diseases
- Immunoglobulin G
- Horse Diseases / diagnosis
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