Department of Surgical Sciences, Department of Surgical Science, UW Veterinary Care, University of Wisconsin-Madison, Madison, WI 53706, USA.
Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA,
J Avian Med Surg. 2023 Jun;37(1):46-56. doi: 10.1647/22-00007.
A 2-year-old male African penguin () was presented to a veterinary teaching hospital for evaluation of a previously diagnosed subclinical, marked regenerative anemia. Physical examination at the zoological institution demonstrated biliverdinuria and pale oral mucous membranes. Diagnostic tests performed on the penguin since the diagnosis and prior to presentation to the veterinary teaching hospital included serial complete blood counts, plasma biochemistry panels, radiographic imaging, blood and plasma heavy metal testing, and infectious disease testing. The abnormal diagnostic test results were consistent with marked regenerative anemia and splenomegaly. At the veterinary teaching hospital, further diagnostic testing was ordered in an attempt to determine the cause of the biliverdinuria and pale oral mucous membranes. The diagnostic tests performed included a full-body contrast computed tomographic scan, upper gastrointestinal endoscopic procedure, bone marrow aspiration and evaluation, saline agglutination testing, blood species polymerase chain reaction screening, a vitamin profile panel, and repeat blood heavy metal testing. The complete blood count demonstrated a marked, regenerative anemia with the presence of dysplastic erythrocytes, and splenomegaly was found on the computed tomographic images without identifying a definitive cause. Primary disease differentials for the diagnosed regenerative anemia included a myelodysplastic syndrome and primary or secondary immune-mediated hemolytic anemia. The penguin was treated with oral prednisolone as an immunomodulatory agent; however, it did not result in a positive treatment response. The patient developed hyporexia, weight loss, and lethargy 2 months post presentation to the veterinary teaching hospital. Additional therapy with cyclophosphamide was initiated, and the penguin improved clinically, but then declined. The patient was euthanized due to a poor quality of life and prognosis 4 months after initial presentation and 1.5 years after the first complete blood count revealed the penguin to be anemic. Microscopic review of submitted postmortem tissue samples demonstrated a monomorphic population of neoplastic small lymphocytes infiltrating the spleen, consistent with splenic small cell lymphoma. The neoplastic cells did not label with the T-cell marker CD3 or B-cell markers CD20, CD79a, and Pax-5.
一只两岁大的雄性非洲企鹅（）因先前诊断出的亚临床再生性贫血而被送到兽医教学医院进行评估。在动物学机构进行的体检显示胆红素尿和口腔黏膜苍白。自诊断以来，在送到兽医教学医院之前，对这只企鹅进行了包括系列全血细胞计数、血浆生化小组、影像学检查、血液和血浆重金属检测以及传染病检测在内的多项诊断性检查。异常的诊断性检查结果与明显的再生性贫血和脾肿大一致。在兽医教学医院，进一步的诊断性检查被要求以确定胆红素尿和口腔黏膜苍白的原因。进行的诊断性测试包括全身对比 CT 扫描、上消化道内镜检查、骨髓抽吸和评估、盐水凝集试验、血液 种聚合酶链反应筛查、维生素谱面板和重复血液重金属检测。全血细胞计数显示明显的再生性贫血，存在红细胞发育不良，CT 图像显示脾肿大，但未确定明确的病因。诊断再生性贫血的主要疾病鉴别诊断包括骨髓增生异常综合征和原发性或继发性免疫介导性溶血性贫血。这只企鹅接受了泼尼松龙口服治疗作为免疫调节剂；然而，这并没有产生积极的治疗反应。在送到兽医教学医院后 2 个月，该患者出现食欲不振、体重减轻和嗜睡。随后开始使用环磷酰胺进行额外的治疗，这只企鹅的临床状况有所改善，但随后又恶化了。由于生活质量和预后较差，该患者在最初就诊后 4 个月，也就是首次全血细胞计数显示企鹅贫血后 1.5 年被安乐死。提交的尸检组织样本的显微镜检查显示，脾脏中浸润着单一形态的小淋巴细胞肿瘤，符合脾小细胞淋巴瘤。肿瘤细胞没有与 T 细胞标记物 CD3 或 B 细胞标记物 CD20、CD79a 和 Pax-5 标记。
