Idiopathic systemic granulomatous disease and macrophage expression of PTHrP in a miniature pony

Idiopathic systemic granulomatous disease, which has been reported in horses, cattle and human beings, is characterized by perivascular granulomatous and lymphoplasmacytic inflammation in many organ systems. Diagnosis is based on the exclusion of possible viral, fungal or bacterial causes. The disease was identified in a miniature pony with widespread lymphoplasmacytic and granulomatous inflammation, special staining techniques having revealed no evidence of any aetiological agent. Skin lesions, which were severe, consisted of hyperkeratosis and serocellular crust formation, with inflammatory infiltrates in a perivascular to diffuse pattern in both the superficial and deep dermis. Inflammatory infiltrates were also present in lymph nodes and around the blood vessels in most organs. Immunohistochemically, both CD3-positive T lymphocytes and BLA36-positive B lymphocytes were identified in the inflammatory infiltrates, and macrophages were immunolabelled for parathyroid hormone-related protein, a factor associated with hypercalcaemia in human beings with granulomatous diseases.