Elevated parathyroid hormone-related protein and hypercalcemia in two dogs with schistosomiasis

Abstract

Two adult dogs were evaluated for hypercalcemia. Diagnostic evaluation identified elevated parathyroid hormone-related protein (PTHrP) and presumptive humoral hypercalcemia of malignancy. At necropsy, schistosomiasis was diagnosed. North American schistosomiasis is caused by Heterobilharzia americana. Clinical findings may include dermatitis, coughing, diarrhea, and anorexia. Clinicopathological findings may include hypercalcemia, hyperglobulinemia, hypoalbuminemia, anemia, and eosinophilia. Diagnosis by fecal examination is difficult. Praziquantel or fenbendazole treatment may be curative or palliative. These are the first reported cases of hypercalcemia with elevated PTHrP in animals without diagnosed malignancy. Elevation of PTHrP has not been previously reported in hypercalcemic humans or in animals with granulomatous inflammation.

Clinical benefits of biochemical markers of bone turnover in Egyptian children with chronic liver diseases

“…This may explain why the elevation of PTH level is due to the impaired liver function rather than secondary hyperparathyroidism [33] . Moreover, elevated PTH-related protein was obser ved with hyperglobulinemia and hypoalbuminemia in dogs with schistosomiasis [35] , and this may explain the obtained positive correlation between PTH and serum total protein levels in patients with HCV infection due to hyperglobulinemia observed in our study.…”

“…In hepatocellular dysfunction some previous studies reported that serum PTH level is high in patients with primar y biliar y cirrhosis [32] , liver cirrhosis [33] , HBV infection [34] , as well as in dogs with schistosomiasis [35] and in children with cholestatic and non-cholestatic liver disease [36] . On the other hand, other studies reported that PTH is unchanged in patients with chronic viral liver disease [37] and post hepatic cirrhosis [38] .…”

Blockade of parathyroid hormone–related protein prevents joint destruction and granuloma formation in streptococcal cell wall–induced arthritis

“…However, in this noninfectious model, liver function was normal in SCW animals with granulomatous livers and remained unchanged with PTHrP antibody treatment (data not shown). Growing evidence suggests that PTHrP may be involved in the pathogenesis of multiple types of granulomatous disorders, because its increased expression has now been documented in sarcoidosis, schistosomiasis, giant cell granulomas, and idiopathic systemic granulomatous disease (47)(48)(49)(50). However, to our knowledge, the results presented here are the first to identify a function for PTHrP in this pathologic process.…”

Lymphosarcoma associated with Heterobilharzia americana infection in a dog

“…Intense chronic granulomatous inflammation and fibrosis are usually associated with schistosome ova within tissues. 8,11,13,19,24 However, an association between canine schistosomiasis and lymphosarcoma has not been described.…”

“…2,19 Clinical signs of canine schistosomiasis may include lethargy, weight loss, anorexia, diarrhea, vomiting, polyuria, and polydipsia; reported clinicopathologic abnormalities include hypercalcemia, hyperglobulinemia, anemia, and eosinophilia. 8,11,13,18,19,24 In infected dogs, adult schistosoma inhabit and lay eggs in the mesenteric venules. The released ova migrate out of the blood vessel and through the intestinal wall to the intestinal lumen or are spread hematogenously to other tissues, primarily the liver.…”