PMID- 35251678
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220502
IS  - 2055-1169 (Electronic)
IS  - 2055-1169 (Linking)
VI  - 8
IP  - 1
DP  - 2022 Jan-Jun
TI  - Cutaneous xanthoma causing hypercalcaemia in a cat.
PG  - 20551169221082050
LID - 10.1177/20551169221082050 [doi]
LID - 20551169221082050
AB  - CASE SUMMARY: A 5-year-old male neutered cat weighing 3.56 kg presented owing to 
      the development of two masses over the dorsal cervical and cranial thoracic 
      areas, as well as weight loss, inappetence and vomiting. Diagnostic tests 
      revealed a grossly lipaemic sample with hypercholesterolaemia (440 mg/dl; 
      reference interval [RI] 90.0-205.0), hypercalcaemia (>16.0 mg/dl [RI 8.0-11.8]) 
      and urine specific gravity 1.022 (RI ⩾1.035). When re-presented 9 months later, 
      fasted blood analyses revealed elevated ionised calcium (1.87 mmol/l [RI 
      1.11-1.38]), persistently elevated total calcium, normal phosphate and persistent 
      minimally concentrated urine with calcium oxalate dihydrate crystals. 
      Ultrasound-guided fine-needle aspiration of the masses produced blood-tinged 
      purulent fluid with negative culture results. Excisional biopsies of both masses 
      were undertaken, and histopathology was consistent with cutaneous xanthoma. No 
      organisms were identified with special staining, and deep-tissue culture did not 
      grow bacteria or fungi. Postoperatively, repeat fasted biochemical analysis 
      revealed persistent hypercholesterolaemia with normal triglycerides, and 
      normalisation of ionised and total calcium levels. Based on these findings, a 
      diagnosis of cutaneous xanthoma causing hypercalcaemia due to primary 
      dyslipidaemia was made. The cat was reported to be significantly improved in 
      comfort and energy levels postoperatively and a transition to a fat-restricted 
      diet was instituted. Eight months after xanthoma removal no recurrence was 
      reported. RELEVANCE AND NOVEL INFORMATION: To our knowledge, this is the first 
      report of cutaneous xanthoma and associated granulomatous inflammation causing 
      hypercalcaemia due to dyslipidaemia in a cat. Familial hypercholesterolaemia is 
      an example of a primary condition that could cause dyslipidaemia in cats, and 
      further studies are warranted to better describe the genetic characteristics. 
      Xanthoma formation and the resultant granulomatous inflammation should be 
      considered in cases of hypercalcaemia.
CI  - (c) The Author(s) 2022.
FAU - Ma, Doris
AU  - Ma D
AUID- ORCID: 0000-0002-9508-9540
AD  - Department of Internal Medicine, Animal Referral Centre, Auckland, New Zealand.
FAU - Romine, Jessica F
AU  - Romine JF
AUID- ORCID: 0000-0002-7306-4115
AD  - Department of Internal Medicine, Animal Referral Centre, Auckland, New Zealand.
FAU - Hardcastle, Michael
AU  - Hardcastle M
AD  - Department of Anatomic Pathology, Gribbles Veterinary Pathology New Zealand, 
      Auckland, New Zealand.
LA  - eng
PT  - Case Reports
DEP - 20220227
PL  - England
TA  - JFMS Open Rep
JT  - JFMS open reports
JID - 101672978
PMC - PMC8891847
OTO - NOTNLM
OT  - Ionised hypercalcaemia
OT  - congenital hypercholesterolaemia
OT  - cutaneous xanthoma
OT  - elevated cholesterol
OT  - elevated ionised calcium
OT  - elevated total calcium
OT  - familial hypercholesterolaemia
OT  - primary dyslipidaemia
OT  - total hypercalcaemia
COIS- Conflict of interest: The authors declared no potential conflicts of interest 
      with respect to the research, authorship, and/or publication of this article.
EDAT- 2022/03/08 06:00
MHDA- 2022/03/08 06:01
PMCR- 2022/02/27
CRDT- 2022/03/07 06:05
PHST- 2022/03/07 06:05 [entrez]
PHST- 2022/03/08 06:00 [pubmed]
PHST- 2022/03/08 06:01 [medline]
PHST- 2022/02/27 00:00 [pmc-release]
AID - 10.1177_20551169221082050 [pii]
AID - 10.1177/20551169221082050 [doi]
PST - epublish
SO  - JFMS Open Rep. 2022 Feb 27;8(1):20551169221082050. doi: 
      10.1177/20551169221082050. eCollection 2022 Jan-Jun.