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Peters-Kennedy J, Löhr CV, Cossic B, Glaser AL, Duhamel GE. Association of equine gammaherpesvirus-5 with facial lymphohistiocytic interface dermatitis in seven adult horses from the United States. Vet Pathol 2023; 60:888-897. [PMID: 37688513 DOI: 10.1177/03009858231197830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2023]
Abstract
Equine herpesvirus-5 (EHV-5) is commonly found in healthy asymptomatic horses worldwide. Although a cause-and-effect relationship has not been thoroughly determined, this virus has been associated with several disease conditions including equine multinodular pulmonary fibrosis (EMPF) and 1 case of interface dermatitis. The authors searched the New York State Animal Health Diagnostic Center database for cases of equine interface dermatitis between 2007 and 2022. Ten cases were identified and scrutinized for viral inclusion bodies which were present in 5 of 10 cases. Two similar cases with interface dermatitis and viral inclusion bodies, which were not part of a retrospective search, were from the Oregon Veterinary Diagnostic Laboratory. The authors describe a total of 7 horses with dermatitis characterized by crusted, alopecic, non-pruritic, non-painful, irregular to annular areas over the face, most commonly the muzzle, for up to several years duration. Histologically, there was a CD3+ T lymphocyte-dominated lymphohistiocytic interface dermatitis with hydropic degeneration, apoptotic keratinocytes, and pigmentary incontinence. Keratinocytes within the upper stratum spinosum and stratum granulosum had glassy pale basophilic intranuclear inclusion bodies consistent with herpesvirus. The presence of EHV-5 was confirmed by quantitative polymerase chain reaction (qPCR) and in situ hybridization in 7 horses and by electron microscopy in 1 horse. One horse later developed EMPF and was euthanized. EHV-5 was not detected with qPCR from 5 control horses and 5 horses with interface dermatitis without histologic evidence of viral inclusion bodies. These are the first cases of facial interface dermatitis associated with EHV-5 reported in the United States.
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Acevedo HD, Hassebroek AM, Leventhal HR, Duhamel GE, Carvallo FR. Colonic T-cell-rich, large B-cell lymphoma associated with equid herpesvirus 5 infection and secondary trans-colonic fistula in a horse. J Vet Diagn Invest 2023; 35:272-277. [PMID: 36786313 PMCID: PMC10185988 DOI: 10.1177/10406387231155414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
A 17-y-old Rocky Mountain gelding was presented to the Virginia-Maryland Veterinary Teaching Hospital because of a 4-wk history of anorexia, weight loss, lethargy, and fever of unknown origin. Abdominal ultrasound revealed lymphadenomegaly of the abdominal and colonic lymph nodes, thickening of the wall of the large colon, and a mass associated with the large colon. The horse was euthanized given a poor prognosis. On autopsy, an ~20-cm diameter mass was found within the mesocolon between the right ventral and right dorsal colon. The mass had invaded through the colonic walls and formed a fistula between the 2 involved lumina. On histologic evaluation, the mass consisted of small numbers of large neoplastic lymphocytes, numerous small lymphocytes, and many foamy macrophages. A diagnosis of T-cell-rich, large B-cell lymphoma was made based on immunohistochemical staining for CD79a, CD3, and Iba1; concurrent infection with equid herpesvirus 5 was confirmed with in-situ hybridization (ISH). To our knowledge, neither a trans-colonic fistula resulting from alimentary lymphoma in a horse nor detection of intralesional equid herpesvirus 5 in equine alimentary lymphoma by ISH has been reported previously.
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Affiliation(s)
- Hernando D. Acevedo
- Faculty of Veterinary Medicine and Zootechnics, University of Tolima (UT), Ibagué, Tolima, Colombia
| | - Anna M. Hassebroek
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA
| | | | - Gerald E. Duhamel
- Department of Biomedical Sciences, Cornell University, Ithaca, NY, USA
| | - Francisco R. Carvallo
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA
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Drozdzewska K, Gehlen H. Markers for internal neoplasia in the horse. Vet Med Sci 2022; 9:132-143. [PMID: 36495211 PMCID: PMC9857019 DOI: 10.1002/vms3.1042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The diagnosis of internal neoplasia in horses is challenging. Increased production of hormones physiologic for adult animals (e.g., adrenocorticotropin, norepinephrine, and erythropoietin) or typical for the foetal phase (alpha-fetoprotein, anti-Müllerian hormone, and parathyroid-hormone-related protein) might aid in tumour diagnostics. Thymidine kinase-1 and alkaline phosphatase are examples of intracellular enzymes, whose activity in the blood may increase in some neoplasia cases. Furthermore, inappropriate production of abnormal monoclonal or autologous antibodies can accompany lymphoma and multiple myeloma. Many of those tumour markers lead to clinical or laboratory changes, called paraneoplastic syndromes, such as hypercalcaemia and erythrocytosis. The interpretation of the results of the tumour marker measurements in horses is complicated due to many factors affecting the markers' concentration or activity (e.g., young age, pregnancy, and inflammation) and other diseases triggering the same changes. Moreover, the presence of paraneoplastic syndromes is inconsistent, which leads to low sensitivity of those substances as tumour markers. In conclusion, screening for neoplasia in horses is not recommended. The measurement of tumour markers should be performed only in risk groups with suspicious clinical or laboratory findings, and the results should be interpreted with caution. It is advisable to add inflammatory markers to the tumour profile or repeat the measurements.
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Affiliation(s)
| | - Heidrun Gehlen
- Equine Clinic, Surgery and RadiologyFreie Universitaet BerlinBerlinGermany
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Badr C, Souiai O, Arbi M, El Behi I, Essaied MS, Khosrof I, Benkahla A, Chabchoub A, Ghram A. Epidemiological and Phylogeographic Study of Equid Herpesviruses in Tunisia. Pathogens 2022; 11:pathogens11091016. [PMID: 36145448 PMCID: PMC9504996 DOI: 10.3390/pathogens11091016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/27/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Equid herpesvirus (EHV) is a contagious viral disease affecting horses, causing illness characterized by respiratory symptoms, abortion and neurological disorders. It is common worldwide and causes severe economic losses to the equine industry. The present study was aimed at investigating the incidence of EHVs, the genetic characterization of Tunisian isolates and a spatiotemporal study, using 298 collected samples from diseased and clinically healthy horses. The global incidence of EHV infection was found to be about 71.81%. EHV2 and EHV5 were detected in 146 (48.99%) and 159 (53.35%) sampled horses, respectively. EHV1 was detected in 11 samples (3.69%); EHV4 was not detected. Co-infections with EHV1-EHV2, EHV1-EHV5 and EHV2-EHV5 were observed in 0.33%, 1.34% and 31.54% of tested horses, respectively. Phylogenetic analyses showed that gB of EHV2 and EHV5 displays high genetic diversity with a nucleotide sequence identity ranging from 88 to 100% for EHV2 and 97.5 to 100% for EHV5. Phylogeography suggested Iceland and USA as the most likely countries of origin of the Tunisian EHV2 and EHV5 isolates. These viruses detected in Tunisia seemed to be introduced in the 2000s. This first epidemiological and phylogeographic study is important for better knowledge of the evolution of equid herpesvirus infections in Tunisia.
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Affiliation(s)
- Chaima Badr
- Laboratory of Epidemiology and Microbiology Veterinary (LR19IPT03), Institute Pasteur of Tunis, University Tunis El Manar, Tunis 1002, Tunisia
- Correspondence:
| | - Oussama Souiai
- Laboratory of Bioinformatics, Biomathematics and Biostatistics (LR16IPT09), Institute Pasteur of Tunis, University Tunis El Manar, Tunis 1002, Tunisia
| | - Marwa Arbi
- Laboratory of Bioinformatics, Biomathematics and Biostatistics (LR16IPT09), Institute Pasteur of Tunis, University Tunis El Manar, Tunis 1002, Tunisia
| | - Imen El Behi
- Laboratory of Epidemiology and Microbiology Veterinary (LR19IPT03), Institute Pasteur of Tunis, University Tunis El Manar, Tunis 1002, Tunisia
| | - Mohamed S. Essaied
- National School of Veterinary Medicine, Sidi Thabet, University of Manouba, La Manouba 2010, Tunisia
| | - Ines Khosrof
- National School of Veterinary Medicine, Sidi Thabet, University of Manouba, La Manouba 2010, Tunisia
| | - Alia Benkahla
- Laboratory of Bioinformatics, Biomathematics and Biostatistics (LR16IPT09), Institute Pasteur of Tunis, University Tunis El Manar, Tunis 1002, Tunisia
| | - Ahmed Chabchoub
- National School of Veterinary Medicine, Sidi Thabet, University of Manouba, La Manouba 2010, Tunisia
- Laboratory of Viruses, Vectors and Hosts (LR20IPT10), Institute Pasteur of Tunis, University Tunis El Manar, Tunis 1002, Tunisia
| | - Abdeljelil Ghram
- Laboratory of Epidemiology and Microbiology Veterinary (LR19IPT03), Institute Pasteur of Tunis, University Tunis El Manar, Tunis 1002, Tunisia
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Gehlen H, Rutenberg D, Simon C, Reinhold-Fritzen B, Drozdzewska K. [Management and hygiene measures during an outbreak of herpes, influenza, strangles or infections with multidrug resistant bacteria]. Tierarztl Prax Ausg G Grosstiere Nutztiere 2022; 50:115-125. [PMID: 35523188 DOI: 10.1055/a-1809-2163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this review is to describe general guidelines of hygiene measures in the horse stable as well as to provide current recommendations for an outbreak of a common infectious disease. General cleanliness, hand hygiene, avoidance of stress, regular deworming, and vaccinations belong to the basic hygiene measures in a horse herd. All new or returning equids should be submitted to a quarantine period as an important prevention measure. Repeated washing and disinfection of hands may prevent spreading of infectious agents to people and horses.The conception of a hygiene plan, including general biosecurity procedures and standard operating procedures in a case of an outbreak of an infectious disease, zoonosis, or colonization with multi-resistant bacteria is strongly recommended. As soon as the disease is suspected, extended hygiene measures including protective clothing, cleaning, disinfection, and isolation of potentially infected animals should be implemented. Prompt confirmation of the causative agent by examination of appropriate samples is crucial. It is important to adjust all safety measures based on the contagious nature of the respective pathogen and its major transmission routes. Apart from a lock-down of the stable, clinic or show grounds, the segregation of horses plays an important role. Implementation of the "traffic light system" is recommended. In this, the red group ("infected") include animals with clinical signs of the disease or that have been tested positive. All horses with possible pathogen contact should be allocated to a yellow group ("suspected") and regularly controlled for the signs of infection and fever. Clinically normal horses without contact to the infected animals belong to the green group ("healthy"). A change of protective clothing and an extensive disinfection should be performed when moving between the groups.The extended hygiene measures are to be maintained until all animals have been tested negative or fail to exhibit clinical signs of the disease for a certain time period.
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Affiliation(s)
- Heidrun Gehlen
- Klinik für Pferde, Fachbereich Veterinärmedizin, Freie Universität Berlin
| | - Dusty Rutenberg
- Klinik für Pferde, Fachbereich Veterinärmedizin, Freie Universität Berlin
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Wang L, Unger L, Sharif H, Eriksson S, Gerber V, Rönnberg H. Molecular characterization of equine thymidine kinase 1 and preliminary evaluation of its suitability as a serum biomarker for equine lymphoma. BMC Mol Cell Biol 2021; 22:59. [PMID: 34906077 PMCID: PMC8670147 DOI: 10.1186/s12860-021-00399-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 12/08/2021] [Indexed: 11/20/2022] Open
Abstract
Background Thymidine kinase 1 (TK1) plays a key role in the synthesis of deoxythymidine triphosphate (dTTP) and is thus important for DNA replication and cell proliferation. The expression of TK1 is highest during S-phase, and it is rapidly degraded after mitosis. In cancer cells, TK1 is upregulated, resulting in leakage of excess TK1 into the blood. Consequently, serum TK1 has been used as a diagnostic and prognostic cancer biomarker, mainly in human medicine. The aims of this work were to characterize equine TK1 and to evaluate its suitability as a serum biomarker for equine lymphoma. Results Equine TK1 was cloned, expressed in E. coli and affinity purified. The purified recombinant horse TK1 showed broad substrate specificity, phosphorylating pyrimidine deoxyribo- and ribonucleosides and, to some extent, purine deoxynucleosides, including anticancer and antiviral nucleoside analogues. ATP was the preferred phosphate donor. Serum TK1 activity was measured in samples collected from horses with confirmed or suspected lymphoma and control horses with and without concurrent diseases. Serum TK1 activity levels were significantly higher in horses with lymphoma (p < 0.0005) and suspected lymphoma (p < 0.02) and in tumour-free groups with diverse diseases (p < 0.03) than in controls without concurrent diseases. There was a significant difference between the lymphoma group and the tumour-free group with diverse diseases (p < 0.0006). Furthermore, receiver operating characteristic analysis revealed a sensitivity of 0.86, a specificity of 0.95 and an AUC (area under the curve) of 0.92 compared to the controls without concurrent diseases, with a sensitivity of 0.97, a specificity of 0.71 and an AUC of 0.88 when compared with the tumour-free group with diverse diseases. Conclusion Equine TK1 showed high specific activity and broader substrate specificity than human TK1. Anticancer and antiviral thymidine analogues were efficiently phosphorylated by horse TK1, suggesting that these analogues might be good candidates for chemotherapy in horses. Serum TK1 activity was significantly higher in horses with lymphoma than in controls. ROC analysis indicated that serum TK1 could serve as a promising cancer biomarker in horses. Supplementary Information The online version contains supplementary material available at 10.1186/s12860-021-00399-x.
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Affiliation(s)
- Liya Wang
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| | - Lucia Unger
- Swiss Institute of Equine Medicine (ISME), Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, and Agroscope, Bern, Switzerland
| | - Hanan Sharif
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden.,Alertix Veterinary Diagnostic AB, SE-392 30, Kalmar, Sweden
| | - Staffan Eriksson
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Vinzenz Gerber
- Swiss Institute of Equine Medicine (ISME), Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, and Agroscope, Bern, Switzerland
| | - Henrik Rönnberg
- Department of Clinical Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Easton-Jones C. Recent advancements in our understanding of equid gammaherpesvirus infections. Equine Vet J 2021; 54:11-23. [PMID: 34519074 DOI: 10.1111/evj.13512] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 06/18/2021] [Accepted: 09/03/2021] [Indexed: 12/19/2022]
Abstract
Equid gammaherpesviruses are ubiquitous and widespread in the equine population. Despite their frequent detection, their contribution to immune system modulation and the pathogenesis of several diseases remains unclear. Genetic variability and the combination of equid gammaherpesvirus strains a horse is infected with might be clinically significant. Initial gammaherpesvirus infection occurs in foals peripartum with latency then established in peripheral blood mononuclear cells. A novel EHV-5 study suggests that following inhalation equid gammaherpesviruses might obtain direct access to T and B lymphocytes via the tonsillar crypts to establish latency. EHV-5 is associated with equine multinodular pulmonary fibrosis, however, unlike with EHV-2 there is currently minimal evidence for its role in milder cases of respiratory disease and poor performance. Transmission is presumed to be via the upper respiratory tract with periodic reactivation of the latent virus in adult horses. Stress of transport has been identified as a risk factor for reactivation and shedding of equine gammaherpesviruses. There is currently a lack of evidence for the effectiveness of antiviral drugs in the treatment of equine gammaherpesvirus infections.
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Manso-Díaz G, Jiménez Martínez MDLÁ, García-Fernández RA, Herrán R, Santiago I. Mediastinal Ectopic Thyroid Carcinoma and Concurrent Multinodular Pulmonary Fibrosis in a Horse. J Equine Vet Sci 2019; 77:8-11. [PMID: 31133322 DOI: 10.1016/j.jevs.2019.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 02/17/2019] [Accepted: 02/18/2019] [Indexed: 11/19/2022]
Abstract
A 30-year-old Standardbred gelding was referred for chronic pleural effusion. Thoracic ultrasound revealed marked bilateral pleural effusion and a large heterogeneous mass within the cranial mediastinum, which extended from the right 5th to the 11th intercostal space. Subsequently, on thoracic radiographs, the cranial mediastinal mass was confirmed, and a nodular interstitial pattern was identified in the lungs. Because of progressive clinical deterioration of the patient, the owners elected humane euthanasia and necropsy was performed. The mediastinal mass was consistent with an ectopic thyroid carcinoma, and the pulmonary nodules represented equine multinodular pulmonary fibrosis (EMPF). This case report describes a type of mediastinal tumor not previously described in horses. Moreover, it shows the need of including EMPF as a possible differential diagnosis for a nodular interstitial pulmonary pattern in conjunction with a mediastinal or other masses.
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Affiliation(s)
- Gabriel Manso-Díaz
- Hospital Clínico Veterinario Complutense, Universidad Complutense de Madrid, Madrid, Spain.
| | | | | | - Ramón Herrán
- Hospital Clínico Veterinario Complutense, Universidad Complutense de Madrid, Madrid, Spain
| | - Isabel Santiago
- Hospital Clínico Veterinario Complutense, Universidad Complutense de Madrid, Madrid, Spain
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Miglio A, Antognoni MT, Morelli C, Gialletti R. Third Eyelid T-cell-Rich Large B-cell Lymphoma Positive to EHV-5 in a Mare—a Case Report. J Equine Vet Sci 2018. [DOI: 10.1016/j.jevs.2018.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Development and application of a quantitative PCR assay to study equine herpesvirus 5 invasion and replication in equine tissues in vitro and in vivo. J Virol Methods 2017; 248:44-53. [PMID: 28455133 DOI: 10.1016/j.jviromet.2017.04.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 04/21/2017] [Accepted: 04/24/2017] [Indexed: 12/20/2022]
Abstract
Equine herpesvirus 5 (EHV-5) infection is associated with pulmonary fibrosis in horses, but further studies on EHV-5 persistence in equine cells are needed to fully understand viral and host contributions to disease pathogenesis. Our aim was to develop a quantitative PCR (qPCR) assay to measure EHV-5 viral copy number in equine cell cultures, blood lymphocytes, and nasal swabs of horses. Furthermore, we used a recently developed equine primary respiratory cell culture system to study EHV-5 pathogenesis at the respiratory tract. PCR primers and a probe were designed to target gene E11 of the EHV-5 genome. Sensitivity and repeatability were established, and specificity was verified by testing multiple isolates of EHV-5, as well as DNA from other equine herpesviruses. Four-week old fully differentiated (mature), newly seeded (immature) primary equine respiratory epithelial cell (ERECs), and equine dermal cell cultures were inoculated with EHV-5 and the cells and supernatants collected daily for 14days. Blood lymphocytes and nasal swabs were collected from horses experimentally infected with equine herpesvirus 1 (EHV-1). The qPCR assay detected EHV-5 at stable concentrations throughout 14days in inoculated mature EREC and equine dermal cell cultures (peaking at 202 and 5861 viral genomes per 106 cellular β actin, respectively). EHV-5 copies detected in the immature EREC cultures increased over 14days and reached levels greater than 10,000 viral genomes per 106 cellular β actin. Moreover, EHV-5 was detected in the lymphocytes of 76% of horses and in the nasal swabs of 84% of horses experimentally infected with EHV-1 pre-inoculation with EHV-1. Post-inoculation with EHV-1, EHV-5 was detected in lymphocytes of 52% of horses while EHV-5 levels in nasal swabs were not significantly different from pre-inoculation levels. In conclusion, qPCR was a reliable technique to investigate viral load in in vivo and in vitro samples, and EHV-5 replication in equine epithelial cells may be influenced by cellular stages of differentiation.
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11
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Diseases of the Nervous System. Vet Med (Auckl) 2017. [PMCID: PMC7322266 DOI: 10.1016/b978-0-7020-5246-0.00014-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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12
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Meichner K, Kraszeski BH, Durrant JR, Grindem CB, Breuhaus BA, Moore PF, Neel JA, Linder KE, Borst LB, Fogle JE, Tarigo JL. Extreme lymphocytosis with myelomonocytic morphology in a horse with diffuse large B‐cell lymphoma. Vet Clin Pathol 2016; 46:64-71. [DOI: 10.1111/vcp.12435] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Kristina Meichner
- Department of Pathology University of Georgia College of Veterinary Medicine Athens GA USA
| | - Blaire H. Kraszeski
- Department of Clinical Sciences College of Veterinary Medicine North Carolina State University Raleigh NC USA
| | - Jessica R. Durrant
- Department of Population Health and Pathobiology College of Veterinary Medicine North Carolina State University Raleigh NC USA
| | - Carol B. Grindem
- Department of Population Health and Pathobiology College of Veterinary Medicine North Carolina State University Raleigh NC USA
| | - Babetta A. Breuhaus
- Department of Clinical Sciences College of Veterinary Medicine North Carolina State University Raleigh NC USA
| | - Peter F. Moore
- Department of Pathology, Microbiology, and Immunology University of California Davis CA USA
| | - Jennifer A. Neel
- Department of Population Health and Pathobiology College of Veterinary Medicine North Carolina State University Raleigh NC USA
| | - Keith E. Linder
- Department of Population Health and Pathobiology College of Veterinary Medicine North Carolina State University Raleigh NC USA
| | - Luke B. Borst
- Department of Population Health and Pathobiology College of Veterinary Medicine North Carolina State University Raleigh NC USA
| | - Jonathan E. Fogle
- Department of Population Health and Pathobiology College of Veterinary Medicine North Carolina State University Raleigh NC USA
| | - Jaime L. Tarigo
- Department of Pathology University of Georgia College of Veterinary Medicine Athens GA USA
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