Equine multisystemic eosinophilic epitheliotropic disease: A case report and review of literature

Abstract

Multisystemic eosinophilic epitheliotropic disease is rare in horses, and usually chronic. In the current case the horse showed an apparently acute onset with high fever and rapid clinical deterioration. A diagnosis of MEED should be considered in horses presenting with weight loss and skin lesions with or without fever. A final diagnosis is based on histological results of biopsy specimens from affected organs.

Multisystemic eosinophilic epitheliotropic disease in a horse in Brazil

“…The histopathological features of this case are similar to those previously described (SANFORD, 1989;HENSON et al, 2002;BOSSELER et al, 2013). Apart from the affected organs in this case, histopathological MEED lesions have also been described in the lungs, liver, salivary glands, esophagus, kidneys, and biliary epithelium (NIMMO WILKIE et al, 1985;BOSSELER et al, 2013;MAULDIN & PETERS-KENNEDY, 2016).…”

“…The condition has not yet been described in Brazil. Clinical signs and age of the affected horse are consistent with those described in the literature for MEED (NIMMO WILKIE et al, 1985;HENSON et al, 2002;BLACK & MACE, 2004;BOSSELER et al, 2013). Cutaneous lesions occurred in 63% of MEED cases (SCHUMACHER et al, 2000) and must be differentiated from skin lesions occurring in dermatophytosis, pemphigus foliaceus, systemic lupus erythematosus, bullous pemphigus, and erythema multiforme (SCOTT & MILLER, 2003).…”

“…Apart from the affected organs in this case, histopathological MEED lesions have also been described in the lungs, liver, salivary glands, esophagus, kidneys, and biliary epithelium (NIMMO WILKIE et al, 1985;BOSSELER et al, 2013;MAULDIN & PETERS-KENNEDY, 2016). Histologically, MEED should be differentiated from equine intestinal pythiosis, since infection by Pythium insidiosum can induce a pyogranulomatous and eosinophilic enteritis that contains foci of necrosis (BEZERRA JÚNIOR et al, 2010).…”

“…Eosinophilia occurs in approximately 14% of MEED cases (BOSSELER et al, 2013;MAULDIN & PETERS-KENNEDY, 2016), and leukocytosis was also previously reported (GEHLEN et al, 2003;BOSSELER et al, 2013). Etiopathogenesis of MEED is unknown; various factors could be involved in the stimulation and chemotaxis of eosinophils that ultimately lead to multisystemic infiltrates (LA PERLE et al, 1998;ROUFOSSE et al, 2004;MAULDIN & PETERS-KENNEDY, 2016).…”

“…Horses with MEED frequently showed areas of alopecia and exudative dermatitis, with epidermal ulcerations, hyperkeratosis, and lichenification. The head and lower parts of the legs, especially the coronary bands, are always involved (NIMMO WILKIE et al, 1985;HENSON et al, 2002;BOSSELER et al, 2013;MAULDIN & PETERS-KENNEDY, 2016).…”