Artifactual hypoglycemia associated with hemotrophic mycoplasma infection in a lamb

Authors

  • Mary Jo Burkhard,

    Corresponding author
    1. Department of Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO. Dr Burkhard now is with the Department of Veterinary Biosciences, The Ohio State University.
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  • Franklyn Garry

    1. Department Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO. Dr Burkhard now is with the Department of Veterinary Biosciences, The Ohio State University.
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Corresponding author: Mary Jo Burkhard, DVM, PhD, Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, 1925 Coffey Rd, Columbus, OH 43210 (burkhard.19@osu.edu).

Abstract

Background: A 35-day-old male lamb with Mycoplasma ovis infection (previously Eperyihrozoon avis) was evaluated because of severe hypoglycemia (serum glucose 4 mg/dL, Hitachi 704 automated chemistry analyzer) inconsistent with the animal's condition. Whole blood glucose concentration measured with a glucometer was 74 mg/dL. Objective: The purpose of this study was to investigate this discrepancy through in vitro evaluation of the patient's blood.

Methods: Blood was incubated alone, with increasing concentrations of plasma, or with equine serum of known glucose concentration for 0,15, 30, and 60 minutes at room temperature; end-point glucose concentrations were compared with blood from a control sheep handled similarly.

Results: A rapid decline in glucose concentration was observed in heparinized or EDTA anticoagulated whole blood from the infected lamb incubated alone or with the equine serum. Glucose concentrations in incubated samples from a control sheep remained stable. Incubation of increasing concentrations of heparinized blood with autologous plasma resulted in decreased glucose concentrations in patient, but not control, blood. As parasitemia decreased after treatment, serum glucose concentration increased, serum lactate concentration decreased, and in vitro glucose concentration stabilized.

Conclusions: These findings are consistent with parasite-associated in vitro glucose consumption. An increase in the lamb's plasma glucose concentration associated with reduction of parasite load suggested excess glucose consumption also may have occurred in vivo.

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