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Pulmonary embolization of fat and bone marrow in cynomolgus Macaques (Macaca fascicularis)
Derek L Fong1, Robert D Murnane, Charlotte E Hotchkiss
1Washington National Primate Research Center, University of Washington, USA. DFong11@wanprc.org
Abstract:
Fat embolization (FE), the introduction of bone marrow elements into circulation, is a known complication of bone fractures. Although FE has been described in other animal models, this study represents the first reported cases of FE and bone marrow embolism in nonhuman primates. Histopathologic findings from cynomolgus macaques (Macaca fascicularis) indicated that in all 5 cases, fat and bone marrow embolization occurred subsequent to multiple bone marrow biopsies. In the most severe case, extensive embolization was associated pulmonary damage consistent with acute respiratory distress syndrome. Fat embolism syndrome (FES) is an infrequent clinical outcome of FE and is triggered by systemic biochemical and mechanical responses to fat in circulation. Although clinical criteria diagnostic of FES were not investigated at the time of death, this severe case may represent the fulminant form of FES, which occurs within 12 h after trauma. Bone marrow biopsy as an etiology of FES has been reported only once in humans. In addition, the association of embolization with bone marrow biopsies suggests that nonhuman primates may be a useful animal model of FE. FE and FES represent important research confounders and FES should be considered as a differential diagnosis for clinical complications subsequent to skeletal trauma.
Insights
Fat embolization (FE) and bone marrow embolism were observed in nonhuman primates following bone marrow biopsies. This suggests primates may serve as a valuable animal model for studying FE and fat embolism syndrome (FES).
Area of Science:
- Veterinary Pathology
- Primate Research
- Cardiopulmonary Medicine
Background:
- Fat embolization (FE) is a known complication of bone fractures, involving bone marrow elements entering circulation.
- While FE has been studied in various animal models, its occurrence in nonhuman primates was previously undocumented.
- Fat embolism syndrome (FES) is a rare but serious clinical outcome of FE.
Observation:
- This study reports the first cases of fat embolization and bone marrow embolism in cynomolgus macaques.
- Histopathologic analysis revealed embolization occurred subsequent to multiple bone marrow biopsies in all observed cases.
- The most severe case exhibited extensive embolization linked to pulmonary damage resembling acute respiratory distress syndrome.
Findings:
- Bone marrow biopsy emerged as a potential cause of FE and bone marrow embolism in this primate model.
- The severe case suggests a potential link to the fulminant form of FES, occurring rapidly after the procedure.
- The findings highlight the significance of FE and FES as potential confounding factors in research involving nonhuman primates.
Implications:
- Nonhuman primates, specifically cynomolgus macaques, may represent a suitable animal model for investigating the pathophysiology of FE and FES.
- Clinicians should consider FES in differential diagnoses for nonhuman primates experiencing respiratory distress or other complications after skeletal trauma or procedures.
- Understanding FE and FES in this model can improve research accuracy and animal welfare in preclinical studies.
