Hypercalcemia and high serum parathyroid hormone-related protein concentration in a horse with multiple myeloma
Year: 2004
Type: article
Study design: Case Report
Abstract: A 13-year-old Morgan gelding was examined because of mild weight loss and delayed shedding of the winter hair coat.The referring veterinarian had not found any physical abnormalities and submitted samples for a CBC and serum biochemical profile.Abnormalities included hyperproteinemia (12.6 g/dL; reference range, 5.4 to 7.8 g/dL), hyperglobulinemia (9.9 g/dL; reference range, 2.2 to 4.4 g/dL), and hypercalcemia (total calcium, 16.8 mg/dL; reference range, 10.0 to 13.5 mg/dL).The horse was referred to the Veterinary Teaching Hospital at the University of Georgia for further evaluation.At the time of initial examination at the University of Georgia 2 months later, the owner reported that there had been no further changes in the horse' s weight and that its appetite was excellent and its attitude, energy level, and performance were normal.On physical examination, the horse appeared bright and alert and was in good to excellent body condition (body weight, 426 kg [937 lb]).Rectal temperature, heart rate, and respiratory rate were within reference limits.Auscultation with a rebreathing bag did not elicit distress or a cough, and normal bronchovesicular sounds were heard.Transrectal palpation did not reveal any clinically important abnormalities.A CBC and serum biochemical profile were performed.Abnormalities included hyperproteinemia (10.9 g/dL; reference range, 5.6 to 7.7 g/dL), hyperglobulinemia (8.5 g/dL; reference range, 2.1 to 5.4 g/dL), and hypercalcemia (total calcium, 16.2 mg/dL [reference range, 10.8 to 12.8 mg/dL]; ionized calcium, 2.56 mmol/L [reference range, 1.58 to 1.90 mmol/L]).Serum albumin concentra-tion (2.4 g/dL; reference range, 2.3 to 3.5 g/dL) was normal.A urinary catheter was inserted, and a urine sample was obtained for urinalysis and determination of fractional excretion of electrolytes.Results of the urinalysis were unremarkable, but fractional urinary excretions of sodium (1.3%), potassium (84.5%), chloride (3.4%), and phosphorus (10.9%) were greater than previously reported reference values. 1 Abdominocentesis was performed.Results of analysis of abdominal fluid were normal, except that protein concentration (3.1 g/dL; reference range, < 2 g/dL) was slightly high.Results of abdominal ultrasonography a were normal other than a slight increase in the echogenicity of the renal cortices, compared with echogenicity of the spleen and liver.Occasional minute hyperechoic foci that did not result in acoustic shadowing were seen throughout the renal parenchyma bilaterally.Samples were submitted for serum protein electrophoresis and quantification of serum parathyroid hormone (PTH) and parathyroid hormone-related protein (PTHrP) concentrations; PTH and PTHrP concentrations were determined by a commercial laboratory b by means of radioimmunoassay. 2 Serum protein electrophoresis revealed polyclonal gammopathy (Figure 1).The PTH concentration was within reference limits (1.3 pmol/L; reference range, 0.25 to 2.0 pmol/L); the PTHrP concentration was less than the limit of detection.
Institution: University of Georgia
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2115075673