Eosinophilic myeloproliferative disorder in a horse

An eosinophilic myeloproliferative disorder resulted in edema and hemorrhagic diathesis in a 10-month-old Standardbred colt. Laboratory abnormalities included severe thrombocytopenia, anemia, mild hypoproteinemia, and marked eosinophilia. Circulating eosinophils were immature or atypical with variation in granule size, disproportionate nuclear to cytoplasmic maturation, and abnormal nuclear size and shape. Bone marrow aspirate had mainly atypical eosinophil precursors, few erythroid precursors, and no megakaryocytes. A blood transfusion and dexamethasone therapy resulted in some improvement; however, the horse was euthanatized due to poor prognosis. Postmortem examination showed gastrointestinal parasitism; histologically the spleen was infiltrated by atypical eosinophils and there were sites of eosinophilopoiesis. The disease was broadly similar to idiopathic hypereosinophilic syndrome in people, but typical cardiac and neurologic involvement of hypereosinophilic syndrome were absent. Progressive myelophthesis and marked eosinophil atypia suggested malignancy.