Detection and Effects on Platelet Function of Anti-Platelet Antibody in Mule Foals with Experimentally Induced Neonatal Alloimmune Thrombocytopenia

Ramírez, Samuel; Gaunt, Stephen D.; McClure, James R.; Oliver, Jean

doi:10.1892/0891-6640(1999)013<0534:daeopf>2.3.co;2

Cited by 10 publications

(11 citation statements)

References 31 publications

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“…Previously reported causes of thrombocytopenia in neonatal foals include neonatal bacterial septicemia and disseminated intravascular coagulation, 3-5 viral infection (equine herpes virus and equine arteritis virus), and neonatal alloimmune thrombocytopenia. [6][7][8] The repeated occurence of this thrombocytopenia in foals from the same mare, and its transient nature, suggest that this condition might be similar to neonatal alloimmune thrombocytopenia, but the ulcerative dermatitis is distinct. Because all foals developed clinical signs at Ͻ4 days of age, an autoimmune-mediated disease was considered unlikely, given the foal's naive immune system.…”

Section: Discussionmentioning

confidence: 99%

Ulcerative Dermatitis, Thrombocytopenia, and Neutropenia in Neonatal Foals

Perkins¹,

Miller²,

Divers³

et al. 2005

J Vet Int Med

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This report describes transient ulcerative dermatitis, severe thrombocytopenia, and mild neutropenia in 6 foals from 4 mares from geographically diverse regions of the United States. The foals presented at Ͻ4 days of age with oral and lingual ulcers, and crusting and erythema around the eyes, muzzle, and perineal, inguinal, axillary, trunk, and neck regions. There was a severe thrombocytopenia (0-30,000 platelets/L), leukopenia (1,200 white blood cells/L), and mild neutropenia (500-1,800 neutrophils/ L). Four of the 6 foals had petechiae and ecchymotic hemorrhages and 3 had bleeding tendencies. Results of examination of a bone marrow biopsy from 1 foal were normal and results of a platelet surface immunoglobulin test in another were negative. Histopathology of the skin in all foals showed subepidermal clefting with subjacent vascular dilation, dermal hemorrhage, and superficial papillary necrosis. The foals were treated supportively with broad-spectrum antibiotics (5/6), corticosteroids (3/6), gastric ulcer prophylaxis (6/6), whole-blood transfusion (4/6), and platelet-rich plasma (1/6). The skin lesions and thrombocytopenia (Ͼ50,000 platelets/L) improved in 2 weeks (4/6). Two foals had a decline in their platelet counts when the steroids were decreased and needed protracted treatment. All foals survived and were healthy as yearlings. Two mares that had 2 affected foals each, upon subsequent pregnancies to different stallions, had healthy foals when an alternate source of colostrum was given. The findings in the cases in this report suggest a possible relationship between colostral antibodies or some other factor in the colostrum and the thrombocytopenia and skin lesions, although further investigation is warranted to confirm or refute this hypothesis.Key words: Dermatopathy; Horse; Neutrophil; Platelet; Skin.T he purpose of this paper is to describe a syndrome of transient ulcerative dermatitis, severe thrombocytopenia with bleeding tendencies, and neutropenia in neonatal foals. The physical examination, clinicopathologic, clinical progress, and histopathology of skin biopsy findings of 6 neonatal foals from geographically diverse regions of the United States will be presented. Materials and MethodsThe medical records of 6 neonatal foals examined between 1998 and 2002 with a transient ulcerative dermatitis and severe thrombocytopenia were summarized. The foals were seen at 3 referral hospitals throughout the United States, including Cornell University Hospital for Animals, Ithaca, NY (n ϭ 2), Washington State University Veterinary Teaching Hospital, Pullman, WA (n ϭ 2), and Peterson and Smith Equine Hospital, Ocala, FL (n ϭ 2). A CBC and skin biopsy were performed on all foals. The skin biopsies were fixed in formalin and the slides were evaluated by 1 dermatologist (WHM) retrospectively for the purposes of publication. Data collected from the record included the signalment and parity of the mare and events (medications, illness, and vaccinations) that occurred during pregnancy and parturition, the health of t...

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Section: Discussionmentioning

confidence: 99%

Ulcerative Dermatitis, Thrombocytopenia, and Neutropenia in Neonatal Foals

Perkins¹,

Miller²,

Divers³

et al. 2005

J Vet Int Med

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“…The syndrome of transient ulcerative dermatitis, thrombocytopenia and neutropenia is likely to be an alloimmune-mediated disorder (Perkins et al 2005), and antiplatelet antibodies have been detected in neonatal thrombocytopenia in clinical (Buechner-Maxwell et al 1997) and experimental settings (Ramirez et al 1999). The clinical findings of the foal of the current report support the role of maternally-derived anti-platelet antibodies, despite the lack of confirmation of platelet-bound immunoglobulin.…”

Section: Discussionmentioning

confidence: 48%

“…The foal had polysynovial effusion due to haemarthrosis, which probably caused the stiff gait at the time of presentation, as acute haemarthrosis induces pain and synovial inflammation (Valentino 2010;Walton et al 2014). Haemarthrosis is usually a result of trauma or a clotting factor disorder (Vallance et al 2012); however, the polysynovial haemarthrosis in our foal was probably due to impaired primary haemostasis from the profound thrombocytopenia and inhibitory effect of antiplatelet antibodies on platelet function (Ramirez et al 1999;Zdravic et al 2016). While haemarthrosis has not previously been reported in horses with thrombocytopenia, it is a rare manifestation of immune-mediated thrombocytopenia in man (Moller and Goldstein 1987) and dogs (Walton et al 2014).…”

Section: Discussionmentioning

confidence: 58%

Thrombocytopenia, neutropenia, ulcerative dermatitis and haemarthrosis in a neonatal foal

Preez

Hughes

2017

Equine Veterinary Education

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Summary A 3‐day‐old Standardbred filly, born from a multiparous mare, was presented for assessment of limb swellings and reduced appetite. Physical examination revealed tachycardia, multifocal petechial and ecchymotic haemorrhages, stiff gait, polysynovial effusion, as well as erosions, multifocal crusting and erythema of the skin. Laboratory examinations revealed adequate transfer of passive immunity, marked thrombocytopenia, moderate neutropenia and anaemia. Aerobic bacterial blood culture was negative. Sanguineous fluid, consistent with haemarthrosis, was obtained by synoviocentesis. The foal was successfully managed with the administration of blood transfusions, an immunosuppressive regimen of corticosteroid medication, systemic antimicrobial medication and supportive care and recovered uneventfully. This report describes a neonatal foal with marked thrombocytopenia and signs of coagulopathy, neutropenia and ulcerative dermatitis consistent with a previously described syndrome. This case emphasises that alloimmune disease should be considered in neonatal foals with haemostatic disturbances or unexplained cytopenia.

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“…1 More recently, immune-mediated thrombocytopenia, because of platelet-associated alloantibody of maternal origin, has been recognized in both horse and mule foals. 4,5 Thrombocytopenia may also be a component of the spectrum of disseminated intravascular coagulation in foals, although this syndrome in neonates has yet to be fully described. 6,7 Pseudothrombocytopenia associated with the use of EDTA anticoagulant has been described in an adult horse but has not, to our knowledge, been documented in the foal.…”

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confidence: 99%

“…8 In our report, because both foals had received adequate colostrum, platelet-associated alloantibody-induced immune-mediated thrombocytopenia was ruled out by appropriate testing. 5 Pseudothrombocytopenia because of cold agglutination was also ruled out, as was EDTAassociated thrombocytopenia. There are reports associating cold platelet agglutination with disease.…”

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confidence: 99%