Concurrent chronic lymphocytic leukemia and primary hyperparathyroidism in a mule

J Vet Intern Med. 2023 May-Jun;37(3):1250-1255. doi: 10.1111/jvim.16714. Epub 2023 Apr 28.

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.

Keywords: endocrinopathy; equine; hypercalcemia; immunohistochemistry; neoplasia.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Equidae
  • Horse Diseases* / diagnosis
  • Horses
  • Hypercalcemia* / diagnosis
  • Hypercalcemia* / veterinary
  • Hyperparathyroidism, Primary* / diagnosis
  • Hyperparathyroidism, Primary* / veterinary
  • Leukemia, Lymphocytic, Chronic, B-Cell* / complications
  • Leukemia, Lymphocytic, Chronic, B-Cell* / diagnosis
  • Leukemia, Lymphocytic, Chronic, B-Cell* / veterinary
  • Lymphocytosis* / veterinary
  • Male