Bovine neonatal pancytopenia
Synonym(s): Bleeding calf syndrome; Formerly called: Idiopathic hemorrhagic diathesis of calves (blood sweating disease)
Introduction
- A fatal bleeding syndrome affecting calves less than four weeks of age.
- Cause: ingestion of colostrum containing alloantibodies from dams vaccinated with a killed Bovine Viral Diarrhea Virus vaccine (Pregsure BVD, Pfizer Animal Health) that contained a novel adjuvant.
- Signs: generalized hemorrhagic diathesis. Bleeding from the skin, nose and rectum. Pyrexia and malaise.
- Diagnosis: history, clinical signs, hematology, post mortem examination and histopathology.
- Treatment: can attempt whole blood transfusion.
- Prognosis: grave.
Geographic incidence
- Reported cases are restricted to mainland Europe, the United Kingdom and New Zealand.
Age predisposition
- Calves <4 weeks old, usually 2-3 weeks old.
Public health considerations
- There are no reported public health risks.
Cost considerations
- Consider cost of treatment carefully as the prognosis is very poor and only a handful of cases will survive.
Special risks
Venous catheterization Intravenous catheters: placement and care or injection of these animals can lead to massive hemorrhage.Pathogenesis
Etiology
- Ingestion of colostrum containing vaccine-induced maternal alloantibodies specific for major histocompatibility complex class I (MHC I). These alloantibodies are found in the colostrum from some cows vaccinated with a vaccine that contains residual cell-line material that generates alloantibodies specific for MHC I.
- Development of clinical signs in the calf depends on the dose of alloantibody consumed by the calf, which depends on the alloantibody titer of the cow. The genotype of the calf MHC I also determines if the individual calf develops the syndrome.
- Pregsure© BVD (Pfizer Animal Health) vaccine was identified as the cause of the initial outbreak of this syndrome which was first seen in 2006/2007. This vaccine was subsequently withdrawn from the market.
Predisposing factors
General
- Vaccination of the dam with a vaccine that contains residual cell-line material that generates alloantibodies to MHC I.
- Cow and calf MHC I genotype.
Specific
- Consumption of colostrum containing alloantibodies to MHC I by calves with a susceptible MHC I genotype. The MHC I genotype of the cow is not generally known so risk cannot be predicted.
Pathophysiology
- In some cows vaccinated with certain vaccines, alloreactive antibodies are produced that target the MHC I complex on bovine cells.
- These alloantibodies are passed from the cow to the calf in colostrum, and absorbed via the gut in the first 24-32 hours of life.
- The alloantibodies bind to white blood cells and platelets in the circulation, as well as to cells in the bone marrow.
- Platelets and white blood cells in the circulation are destroyed first, followed by destruction of the hematopoietic precursors in the bone marrow. This is demonstrated diagnostically by a thrombocytopenia and leukocytopenia on hematology, and replacement of hematopoietic tissue by abnormal tissue in the bone marrow on histology (panmyelophthisis/ trilineage hypoplasia).
- Circulating red blood cells are not damaged, but a normochromic, normocytic, nonregenerative Anemia Anemia: overview can develop in response to the loss of precursors in the bone marrow.
Timecourse
- A reduction in the number of circulating white blood cells and platelets can be seen as early as four hours after ingestion of colostrum containing alloantibodies.
- Most calves die within 24-48 h of the onset of clinical signs.
Epidemiology
- Affects neonatal calves, <4 weeks of age.
- Generally, has a low incidence with only a few cases reported per farm, occasional larger outbreaks may be seen with up to 5-10% of calves affected. Incidence is reported to be higher in herds that have received multiple doses of the vaccine.
- Dams which have had an affected calf will not necessarily have affected calves at their next calving.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed Papers
- Recent references from PubMed and VetMedResource.
- Benedictus L & Bell C R (2017) The risks of using allogeneic cell lines for vaccine production: the example of Bovine Neonatal Pancytopenia. Expert Review of Vaccines 16, 65-71 PubMed.
- Reichmann F, Pfitzner A, Rademacher G, Schwedinger E et al (2016) Incidence of bovine neonatal pancytopenia in 243 farms in Germany. BMC Vet Res 12, 220 PubMed.
- Benedictus L, Luteijn R D, Otten H, Jan Lebbink R et al (2015) Pathogenicity of Bovine Neonatal Pancytopenia-associated vaccine-induced alloantibodies correlates with Major Histocompatibility Complex class I expression. Scientific Reports 5, 12748 PubMed.
- Lambton S L, Colloff A D, Smith R P, Caldow G L et al (2012) Factors Associated with Bovine Neonatal Pancytopenia (BNP) in Calves: A Case-Control Study. PLoS ONE 7, e34183 PubMed.
- Bell C (2011) Bleeding disorders in cattle. In Practice 33, 106-115.
- Bell C (2011) Bovine Neonatal Pancytopenia or bleeding calf syndrome. Livestock 16, 24-28.
- Bell C R, Scott P R, Kerr M G & Willoughby K (2010) Possible preventive strategy for bovine neonatal pancytopenia. Vet Rec 167, 758 PubMed.
- Bell C R, Scott P R, Sargison N D, Wilson D J et al (2010) Idiopathic bovine neonatal pancytopenia in a Scottish beef herd. Vet Rec 167, 938-40 PubMed.
Other sources of information
- Buergelt C D, Clark E G & Del Piero F (2017) Bovine pathology: a text and color atlas. CAB International 2017.
Organisation(s)
- University of Nottingham.
- Farm Post Mortems Ltd.