Analytical performance specifications (APS) are vital for method evaluation and quality control validation. However, the limited availability of biological variation (BV) data, regulatory guidelines, and expert opinion (EO) may present challenges in veterinary medicine. The empirical biological variation (EBV) approach, based on population reference intervals (pRI), has emerged as an alternative method to derive APS in human medicine.
Objectives
This study aimed to assess the practicality and usefulness of the EBV approach in deriving performance limits for various measurands in dogs and cats.
Methods
Eight hematology and 13 biochemistry measurands were analyzed in dogs and cats. Estimates of combined biologic variation based on traditional biological (CVB) and EBV-derived (CVE*) formulas were calculated and assessed for evidence of correlation. Performance limits for expanded uncertainty/total error and imprecision were compared among EO, BV, and EBV.
Results
Strong and significant correlations were found between CVB and CVE* for both dogs (r = .86, p < .00001) and cats (r = 0.95, p < .00001). The EBV-derived APS were generally comparable to EO and BV, with a subjective criterion of 1.5% difference for imprecision and 3% for total error/expanded uncertainty.
Conclusion
The EBV approach, using pRI, shows promise as a surrogate marker for biological variation and as a practical tool for determining performance limits in dogs and cats. Assuming accurate pRI generated on analyzers with stable analytical performance, this approach could offer benefits when expert recommendations or robust BV studies are lacking or yield conflicting results. Further research is needed to explore the applicability and advantages of the EBV in veterinary medicine.
{"title":"Are analytical performance specifications derived from reference intervals of any use in the veterinary clinical laboratory? A preliminary study on the empirical biological variation model","authors":"Simone Manzocchi, Liesl J. van Rooyen","doi":"10.1111/vcp.13317","DOIUrl":"10.1111/vcp.13317","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Analytical performance specifications (APS) are vital for method evaluation and quality control validation. However, the limited availability of biological variation (BV) data, regulatory guidelines, and expert opinion (EO) may present challenges in veterinary medicine. The empirical biological variation (EBV) approach, based on population reference intervals (pRI), has emerged as an alternative method to derive APS in human medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to assess the practicality and usefulness of the EBV approach in deriving performance limits for various measurands in dogs and cats.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eight hematology and 13 biochemistry measurands were analyzed in dogs and cats. Estimates of combined biologic variation based on traditional biological (CV<sub>B</sub>) and EBV-derived (CV<sub>E</sub>*) formulas were calculated and assessed for evidence of correlation. Performance limits for expanded uncertainty/total error and imprecision were compared among EO, BV, and EBV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Strong and significant correlations were found between CV<sub>B</sub> and CV<sub>E</sub>* for both dogs (<i>r</i> = .86, <i>p</i> < .00001) and cats (<i>r</i> = 0.95, <i>p</i> < .00001). The EBV-derived APS were generally comparable to EO and BV, with a subjective criterion of 1.5% difference for imprecision and 3% for total error/expanded uncertainty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The EBV approach, using pRI, shows promise as a surrogate marker for biological variation and as a practical tool for determining performance limits in dogs and cats. Assuming accurate pRI generated on analyzers with stable analytical performance, this approach could offer benefits when expert recommendations or robust BV studies are lacking or yield conflicting results. Further research is needed to explore the applicability and advantages of the EBV in veterinary medicine.</p>\u0000 </section>\u0000 </div>","PeriodicalId":23593,"journal":{"name":"Veterinary clinical pathology","volume":"53 S1","pages":"86-95"},"PeriodicalIF":1.2,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carolina Azevedo, Alisa Rassin, Emily E. Brenner, James F. X. Wellehan, Carolyn Cray, Nicole I. Stacy
{"title":"What is your diagnosis? A blood film and saliva direct smear from two inland bearded dragons (Pogona vitticeps)","authors":"Carolina Azevedo, Alisa Rassin, Emily E. Brenner, James F. X. Wellehan, Carolyn Cray, Nicole I. Stacy","doi":"10.1111/vcp.13326","DOIUrl":"10.1111/vcp.13326","url":null,"abstract":"","PeriodicalId":23593,"journal":{"name":"Veterinary clinical pathology","volume":"53 S2","pages":"158-160"},"PeriodicalIF":1.2,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rose D. Nolen-Walston, Darko Stefanoski, Francisco O. Conrado
Background
Leukergy is the phenomenon of aggregation of leukocytes on a peripheral blood film, and in humans, it is used as an indicator of systemic inflammation and infection.
Objectives
To assess the association of leukergy on blood film examination with biochemical and clinical evidence of systemic inflammation, infection, neoplasia, or specific organ system disease.
Methods
A case–control study using retrospective analysis (2017–2022) identified all canine and feline patients that had been presented to an academic referral center with a finding of leukergy on peripheral blood film and an equal number of species-matched controls.
Results
A total of 127 cases (canine n = 44, feline n = 83) were identified, as well as 127 controls. Feline samples were 7.6× more likely to exhibit leukergy (0.019%) than canine (0.0025%). A positive association was noted between leukergy and higher globulin concentrations in dogs (marginal difference 0.5 mg/dL, P = .016) and cats (marginal difference 0.67 mg/dL, P = <.001). Cats with leukergy had higher WBC counts and were less likely to be diagnosed with cardiac or urinary tract disease than controls. Dogs with leukergy had lower WBC counts and were more likely to be febrile but were less likely to have urinary tract disease than controls. No association was found with neutrophil toxic change or band forms, systemic antimicrobial therapy, or signalment.
Conclusions
We conclude that there is a positive association between increased globulin concentrations and leukergy and inconsistent associations between leukergy and other markers of inflammation or infection. Leukergy is rare overall but markedly more common in cats than dogs.
{"title":"Association of leukergy (in vitro leukocyte aggregation) with systemic inflammation in dogs and cats (2017–2022)","authors":"Rose D. Nolen-Walston, Darko Stefanoski, Francisco O. Conrado","doi":"10.1111/vcp.13325","DOIUrl":"10.1111/vcp.13325","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Leukergy is the phenomenon of aggregation of leukocytes on a peripheral blood film, and in humans, it is used as an indicator of systemic inflammation and infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the association of leukergy on blood film examination with biochemical and clinical evidence of systemic inflammation, infection, neoplasia, or specific organ system disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A case–control study using retrospective analysis (2017–2022) identified all canine and feline patients that had been presented to an academic referral center with a finding of leukergy on peripheral blood film and an equal number of species-matched controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 127 cases (canine <i>n</i> = 44, feline <i>n</i> = 83) were identified, as well as 127 controls. Feline samples were 7.6× more likely to exhibit leukergy (0.019%) than canine (0.0025%). A positive association was noted between leukergy and higher globulin concentrations in dogs (marginal difference 0.5 mg/dL, <i>P</i> = .016) and cats (marginal difference 0.67 mg/dL, <i>P</i> = <.001). Cats with leukergy had higher WBC counts and were less likely to be diagnosed with cardiac or urinary tract disease than controls. Dogs with leukergy had lower WBC counts and were more likely to be febrile but were less likely to have urinary tract disease than controls. No association was found with neutrophil toxic change or band forms, systemic antimicrobial therapy, or signalment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We conclude that there is a positive association between increased globulin concentrations and leukergy and inconsistent associations between leukergy and other markers of inflammation or infection. Leukergy is rare overall but markedly more common in cats than dogs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":23593,"journal":{"name":"Veterinary clinical pathology","volume":"53 1","pages":"40-46"},"PeriodicalIF":1.2,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jill M. Schroeder, Hsiu-Yung C. Lee, Albert E. Schultze
Background
The Sysmex XN-1000V automated hematology analyzer with multispecies software was released in June 2017 for use in research laboratories. Laser light, impedance, fluorescent staining, and fluorescent flow cytometry are used to analyze whole blood for CBC, reticulocyte counts, and WBC counts, including a 5-part differential leukocyte analysis.
Objectives
A side-by-side comparison of the Sysmex XN-1000V with the Siemens ADVIA 120 in analyzing blood from healthy mice and rats will provide insight into the performance of the new analyzer and its capabilities for use in drug development studies. Method correlation analyses on normal mouse and rat hematology data collected with both analyzers and manual reference methods will help determine the reliability of the data produced using the Sysmex XN-1000V analyzer.
Methods
Whole blood samples collected in K2EDTA from healthy CD-1 mice and CD Sprague–Dawley rats were analyzed in parallel with the XN-1000V and ADVIA 120 analyzers. Male and female mice, approximately 6–9 weeks old, and male and female rats, approximately 7–9 weeks old, were included in this study. Manual reference methods for WBC differential leukocyte analysis and packed cell volume (PCV) measurements were also performed. EP Evaluator version 11.2 (Data Innovations LLC, South Burlington, VT, USA) was used for method comparison statistical analysis.
Results
Most hematologic parameters for naïve mice and rats achieved correlation in the fair to excellent range, with the majority showing very good to excellent correlation with low biases (<11.0%) for cohorts analyzed separately and when cohort data were combined.
Conclusions
The Sysmex XN-1000V Hematology Analyzer provided comparable results to those obtained from the Siemens ADVIA 120. We found the Sysmex XN-1000V Hematology Analyzer to be acceptable for use in drug development studies for rats and mice.
{"title":"Performance evaluation of the Sysmex XN-1000V in side-by-side comparison with the Siemens ADVIA 120 and manual methods for healthy CD Sprague–Dawley rats and CD-1 mice","authors":"Jill M. Schroeder, Hsiu-Yung C. Lee, Albert E. Schultze","doi":"10.1111/vcp.13314","DOIUrl":"10.1111/vcp.13314","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Sysmex XN-1000V automated hematology analyzer with multispecies software was released in June 2017 for use in research laboratories. Laser light, impedance, fluorescent staining, and fluorescent flow cytometry are used to analyze whole blood for CBC, reticulocyte counts, and WBC counts, including a 5-part differential leukocyte analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>A side-by-side comparison of the Sysmex XN-1000V with the Siemens ADVIA 120 in analyzing blood from healthy mice and rats will provide insight into the performance of the new analyzer and its capabilities for use in drug development studies. Method correlation analyses on normal mouse and rat hematology data collected with both analyzers and manual reference methods will help determine the reliability of the data produced using the Sysmex XN-1000V analyzer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Whole blood samples collected in K<sub>2</sub>EDTA from healthy CD-1 mice and CD Sprague–Dawley rats were analyzed in parallel with the XN-1000V and ADVIA 120 analyzers. Male and female mice, approximately 6–9 weeks old, and male and female rats, approximately 7–9 weeks old, were included in this study. Manual reference methods for WBC differential leukocyte analysis and packed cell volume (PCV) measurements were also performed. EP Evaluator version 11.2 (Data Innovations LLC, South Burlington, VT, USA) was used for method comparison statistical analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most hematologic parameters for naïve mice and rats achieved correlation in the fair to excellent range, with the majority showing very good to excellent correlation with low biases (<11.0%) for cohorts analyzed separately and when cohort data were combined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Sysmex XN-1000V Hematology Analyzer provided comparable results to those obtained from the Siemens ADVIA 120. We found the Sysmex XN-1000V Hematology Analyzer to be acceptable for use in drug development studies for rats and mice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":23593,"journal":{"name":"Veterinary clinical pathology","volume":"53 1","pages":"8-39"},"PeriodicalIF":1.2,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The objective of a quality system is to provide accurate and reliable results for clinical decision-making. One part of this is Quality Control (QC) validation. QC validation is not routinely applied in veterinary laboratories. This leads to the inappropriate usage of random QC rules without knowing the Probability of error detection (Ped) and Probability of false rejection (Pfr) of a method. In this paper, we will discuss why QC validation is important, when it should be undertaken, why QC validation is done, and why it is not commonly done. We will present the role of total analytical error (TEa) in the QC validation process and the challenges when a consensus TEa has not been published. Finally, we will also discuss the possibilities of ‘gray zone’ determinations and mention the effects of bias on the quality of results. Reasons for the low prevalence of performing QC validation may include (a) lack of familiarity with the concept, (b) lack of time and resources needed to conduct QC validation, and (c) lack of TEa goal for some measurands. If no TEa is available, the user may elect to use a ‘reverse approach’ to QC validation. This uses the CV and bias generated from the evaluation of QC measurements, specifying Ped, Pfr, and N (number of QC measurements/run). This identifies the lowest total error that can be controlled under these defined conditions, thus enabling the laboratory to have an estimate of the ‘gray zone’ associated with results generated with a specific assay.
{"title":"The importance of quality control validation and relationships with total error quality goals and bias in the interpretation of laboratory results","authors":"Kathleen Freeman, Stefanie Klenner-Gastreich, Jérémie Korchia","doi":"10.1111/vcp.13321","DOIUrl":"10.1111/vcp.13321","url":null,"abstract":"<p>The objective of a quality system is to provide accurate and reliable results for clinical decision-making. One part of this is Quality Control (QC) validation. QC validation is not routinely applied in veterinary laboratories. This leads to the inappropriate usage of random QC rules without knowing the Probability of error detection (<i>P</i><sub>ed</sub>) and Probability of false rejection (<i>P</i><sub>fr</sub>) of a method. In this paper, we will discuss why QC validation is important, when it should be undertaken, why QC validation is done, and why it is not commonly done. We will present the role of total analytical error (TEa) in the QC validation process and the challenges when a consensus TEa has not been published. Finally, we will also discuss the possibilities of ‘gray zone’ determinations and mention the effects of bias on the quality of results. Reasons for the low prevalence of performing QC validation may include (a) lack of familiarity with the concept, (b) lack of time and resources needed to conduct QC validation, and (c) lack of TEa goal for some measurands. If no TEa is available, the user may elect to use a ‘reverse approach’ to QC validation. This uses the CV and bias generated from the evaluation of QC measurements, specifying <i>P</i><sub>ed</sub>, <i>P</i><sub>fr</sub>, and <i>N</i> (number of QC measurements/run). This identifies the lowest total error that can be controlled under these defined conditions, thus enabling the laboratory to have an estimate of the ‘gray zone’ associated with results generated with a specific assay.</p>","PeriodicalId":23593,"journal":{"name":"Veterinary clinical pathology","volume":"53 S1","pages":"65-74"},"PeriodicalIF":1.2,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kathryn H. Shaffert, Kayla B. Sample, Jennifer L. Grady, Gisela Martinez-Romero, Francisco O. Conrado
{"title":"What is your diagnosis? Fine needle aspirate from a cutaneous mass in a cat","authors":"Kathryn H. Shaffert, Kayla B. Sample, Jennifer L. Grady, Gisela Martinez-Romero, Francisco O. Conrado","doi":"10.1111/vcp.13318","DOIUrl":"10.1111/vcp.13318","url":null,"abstract":"","PeriodicalId":23593,"journal":{"name":"Veterinary clinical pathology","volume":"53 S2","pages":"112-115"},"PeriodicalIF":1.2,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sydney A. Hastain, Lauren Mumm, Sarah Ozawa, Olivia Petritz, Chris Gaudette, Brigid V. Troan, Devorah M. Stowe
A 26-year-old female sulfur-crested cockatoo (Cacatua galerita) was evaluated for vocalizing through the night and extending her right wing. Physical examination revealed a large, firm mass extending from the humerus to the distal aspect of the elbow. Computed tomography confirmed a large aggressive mass of the right distal humerus with a large soft tissue component, severe osteolysis, and adjacent periosteal proliferation. Fine-needle aspirates of the mass were most compatible with sarcoma, and osteosarcoma was prioritized. An unstained slide was treated with nitroblue tetrazolium chloride/5-bromo-4-chloro-3-indolyl phosphate toluidine salt-phosphatase (NBT/BCIP) substrate for ALP detection and was strongly positive, confirming a diagnosis of osteosarcoma. A month later, the patient underwent wing amputation and arrested during recovery from anesthesia. Post-mortem examination and histopathology were consistent with osteosarcoma. This case report highlights a rare occurrence of osteosarcoma in a cockatoo as well as its cytologic and histologic features. Additionally, this report provides support for NBT/BCIP application in ALP-expressing tumors, a cytochemical stain that has been minimally investigated in avian species.
对一只 26 岁的雌性硫冠凤头鹦鹉（Cacatua galerita）进行了评估，发现它在夜间发声并伸展右翼。体格检查发现一个大而坚实的肿块从肱骨延伸到肘部远端。计算机断层扫描证实，右侧肱骨远端有一个巨大的侵袭性肿块，肿块中含有大量软组织成分、严重的骨溶解和邻近的骨膜增生。肿块的细针穿刺最符合肉瘤的特征，因此骨肉瘤被列为优先考虑的病例。用硝基蓝氯化四氮唑/5-溴-4-氯-3-吲哚磷酸甲苯盐-磷酸酶（NBT/BCIP）底物检测ALP，结果呈强阳性，确诊为骨肉瘤。一个月后，患者接受了截肢手术，并在麻醉恢复过程中死亡。死后检查和组织病理学结果与骨肉瘤一致。本病例报告重点介绍了凤头鹦鹉骨肉瘤的罕见病例及其细胞学和组织学特征。此外，该报告还支持将 NBT/BCIP 应用于 ALP 表达的肿瘤，而这种细胞化学染色法在鸟类中的应用还很少。
{"title":"Osteosarcoma of the wing in a sulfur-crested cockatoo","authors":"Sydney A. Hastain, Lauren Mumm, Sarah Ozawa, Olivia Petritz, Chris Gaudette, Brigid V. Troan, Devorah M. Stowe","doi":"10.1111/vcp.13322","DOIUrl":"10.1111/vcp.13322","url":null,"abstract":"<p>A 26-year-old female sulfur-crested cockatoo (<i>Cacatua galerita</i>) was evaluated for vocalizing through the night and extending her right wing. Physical examination revealed a large, firm mass extending from the humerus to the distal aspect of the elbow. Computed tomography confirmed a large aggressive mass of the right distal humerus with a large soft tissue component, severe osteolysis, and adjacent periosteal proliferation. Fine-needle aspirates of the mass were most compatible with sarcoma, and osteosarcoma was prioritized. An unstained slide was treated with nitroblue tetrazolium chloride/5-bromo-4-chloro-3-indolyl phosphate toluidine salt-phosphatase (NBT/BCIP) substrate for ALP detection and was strongly positive, confirming a diagnosis of osteosarcoma. A month later, the patient underwent wing amputation and arrested during recovery from anesthesia. Post-mortem examination and histopathology were consistent with osteosarcoma. This case report highlights a rare occurrence of osteosarcoma in a cockatoo as well as its cytologic and histologic features. Additionally, this report provides support for NBT/BCIP application in ALP-expressing tumors, a cytochemical stain that has been minimally investigated in avian species.</p>","PeriodicalId":23593,"journal":{"name":"Veterinary clinical pathology","volume":"53 1","pages":"111-115"},"PeriodicalIF":1.2,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vcp.13322","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexandria Argue, Shawn Thomas, Sarah Cudd, Laura McCarthy, Elise E. B. LaDouceur
{"title":"What is your diagnosis? Cranial coelomic mass in a western hognose snake (Heterodon nasicus)","authors":"Alexandria Argue, Shawn Thomas, Sarah Cudd, Laura McCarthy, Elise E. B. LaDouceur","doi":"10.1111/vcp.13324","DOIUrl":"10.1111/vcp.13324","url":null,"abstract":"","PeriodicalId":23593,"journal":{"name":"Veterinary clinical pathology","volume":"53 S2","pages":"161-163"},"PeriodicalIF":1.2,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Megan J. Crawford, Allison R. Rogich, Michael A. Scott, Cynthia A. Lucidi
<p>An 8-year-old spayed female Labrador retriever that was presented for a wellness examination at a referring practice had mild anemia with a hematocrit that progressed from 32% to 25% over the next 5 weeks. The dog's reticulocyte concentration was 26 400/μL on day 23, supporting nonregenerative anemia, and no cause was apparent from clinical and laboratory findings. This prompted the submission of bone marrow core and aspirate samples to our laboratory on day 38. These revealed ineffective erythroid hyperplasia with complete maturation but a predominance of rubricytes, rubriphagocytosis, mild lymphoplasmacytosis, and mild to regionally severe collagen myelofibrosis, all supportive of precursor-targeted immune-mediated anemia (PIMA).<span><sup>1</sup></span> Hemosiderin was markedly increased in aspirate smears and in most regions of the core. No blood transfusions had been given. Immunosuppressive treatment with prednisone was started, but the dog was euthanized 10 days later due to poor clinical progression.</p><p>Plasma cells in the bone marrow commonly contained coarse crystalline cytoplasmic inclusions that were green to brown in aspirate smears (Wright-Giemsa stain) and golden-brown in tissue sections (H&E stain) (Figure 1); the plasma cells otherwise lacked atypia. The granules were suggestive of iron, and Prussian blue positivity confirmed iron-rich inclusions. Histologic sections of liver collected at necropsy showed no increase in iron within hepatocytes or Kupffer cells.</p><p>Bone marrow siderotic plasma cells are rarely reported in nonalcoholic human patients, and the authors are unaware of reports in domestic mammals. In people, they have been associated mostly with conditions involving altered iron homeostasis and/or ineffective erythropoiesis: (1) systemic or marrow hemosiderosis from iron-loading anemias (e.g., megaloblastic anemia, sideroblastic anemias, refractory anemia with multilineage dysplasia, and pyruvate kinase-deficiency), recurrent transfusions, or hereditary hemochromatosis,<span><sup>2</sup></span> but not with iron accumulation from chronic inflammation,<span><sup>2, 3</sup></span> and (2) marrow disease secondary to chronic alcoholism, which is associated with nutritional deficiencies and megaloblastic or sideroblastic anemias with ineffective erythropoiesis and low to high amounts of hemosiderin.<span><sup>2, 4</sup></span> More rarely, plasma cell iron inclusions have been reported in people without clear evidence of altered iron homeostasis or ineffective erythropoiesis, for example, a minority of people with malignancies, including plasma cell myeloma.<span><sup>3, 5</sup></span> Similar to most affected people, the dog in this report had ineffective erythropoiesis and increased marrow hemosiderin that suggests altered iron homeostasis, perhaps related to increased erythroferrone production.<span><sup>6</sup></span> In people, transmission electron microscopy of siderotic plasma cells has shown increased
{"title":"An IRONic case of PIMA","authors":"Megan J. Crawford, Allison R. Rogich, Michael A. Scott, Cynthia A. Lucidi","doi":"10.1111/vcp.13323","DOIUrl":"10.1111/vcp.13323","url":null,"abstract":"<p>An 8-year-old spayed female Labrador retriever that was presented for a wellness examination at a referring practice had mild anemia with a hematocrit that progressed from 32% to 25% over the next 5 weeks. The dog's reticulocyte concentration was 26 400/μL on day 23, supporting nonregenerative anemia, and no cause was apparent from clinical and laboratory findings. This prompted the submission of bone marrow core and aspirate samples to our laboratory on day 38. These revealed ineffective erythroid hyperplasia with complete maturation but a predominance of rubricytes, rubriphagocytosis, mild lymphoplasmacytosis, and mild to regionally severe collagen myelofibrosis, all supportive of precursor-targeted immune-mediated anemia (PIMA).<span><sup>1</sup></span> Hemosiderin was markedly increased in aspirate smears and in most regions of the core. No blood transfusions had been given. Immunosuppressive treatment with prednisone was started, but the dog was euthanized 10 days later due to poor clinical progression.</p><p>Plasma cells in the bone marrow commonly contained coarse crystalline cytoplasmic inclusions that were green to brown in aspirate smears (Wright-Giemsa stain) and golden-brown in tissue sections (H&E stain) (Figure 1); the plasma cells otherwise lacked atypia. The granules were suggestive of iron, and Prussian blue positivity confirmed iron-rich inclusions. Histologic sections of liver collected at necropsy showed no increase in iron within hepatocytes or Kupffer cells.</p><p>Bone marrow siderotic plasma cells are rarely reported in nonalcoholic human patients, and the authors are unaware of reports in domestic mammals. In people, they have been associated mostly with conditions involving altered iron homeostasis and/or ineffective erythropoiesis: (1) systemic or marrow hemosiderosis from iron-loading anemias (e.g., megaloblastic anemia, sideroblastic anemias, refractory anemia with multilineage dysplasia, and pyruvate kinase-deficiency), recurrent transfusions, or hereditary hemochromatosis,<span><sup>2</sup></span> but not with iron accumulation from chronic inflammation,<span><sup>2, 3</sup></span> and (2) marrow disease secondary to chronic alcoholism, which is associated with nutritional deficiencies and megaloblastic or sideroblastic anemias with ineffective erythropoiesis and low to high amounts of hemosiderin.<span><sup>2, 4</sup></span> More rarely, plasma cell iron inclusions have been reported in people without clear evidence of altered iron homeostasis or ineffective erythropoiesis, for example, a minority of people with malignancies, including plasma cell myeloma.<span><sup>3, 5</sup></span> Similar to most affected people, the dog in this report had ineffective erythropoiesis and increased marrow hemosiderin that suggests altered iron homeostasis, perhaps related to increased erythroferrone production.<span><sup>6</sup></span> In people, transmission electron microscopy of siderotic plasma cells has shown increased ","PeriodicalId":23593,"journal":{"name":"Veterinary clinical pathology","volume":"52 4","pages":"546-547"},"PeriodicalIF":1.2,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vcp.13323","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139049370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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