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Mineralization, Pigmentation, & Amyloidosis (Pathologic Mineralization…

- - - - Causes of hypercalcemia
        
        Vitamin D toxicity
        
        Destruction of bone from primary or metastatic neoplasia (rare)
        
        Hypercalcemia of malignancy (PTH-rP produced by tumors)
        
        Renal failure--only sometimes (most common in horses)
        
        Primary hyperparathyroidism (due to parathyroid adenomas)
  - - - Parietal pleura
      - Left atrium
      - Pulomary interstitum
      - Gastric mucosa
      - Kidneys
      - Tongue
  - - - Hyperadrenocorticism: endogenous or exogenous
      - Calcification of dermal collagen
    - - Dermis and tongue
      - Young and large breed dogs (also horses)
- - - - Hemosiderin
        
        Globular golden-yellow to yellow-brown pigement
        
        Contains iron (positive Prussian blue staining)
        
        Location: within macrophages & at sites of RBC breakdown following hemorrhage
        
        Can accumulate in parenchymal cells of organs
        
        Liver, spleen, lymph nodes
      - Hematoidin
      - Bilirubin
        
        Green-brown, amorphous globular pigment
        
        Does not contain iron
        
        Hyperbilirubinemia = icterus (jaundice)
        
        Types of Icterus
        
        Prehepatic
        
        Hemolysis (immune mediated, infection, metabolic, trauma, toxin), increased unconjugated bilirubin (at first)
        
        Hepatic
        
        Liver disease (compromises ability to uptake and excrete bilirubin, increased conjugated and unconjugated bilirubin)
        
        Posthepatic
        
        Bile duct obstruction (increased conjugated bilirubin) ultimately increases in conjugated bilirubin develop with prehepatic, hepatic, and posthepatic causes
        
        Major component of bile (it is a waste product it must be excreted)
        
        Majority of bilirubin is derived from the breakdown of erythrocytes
      - Hemoglobin
        
        Oxygen carrying protein in erythrocytes
        
        Globin +heme (iron)
        
        When things go wrong
        
        Contusion
        
        Porphyrins
        
        Group of hereditary and acquired disorders, accumulate due to abnormalities in the heme synthesis pathway
        
        Carboxyhemoglobin (carbon monoxide poisoning)
        
        Methemoglobin (ferrous ion -> ferric ion), toxicity of nitrites (plants), acetaminophen, naphthalene, some local anesthetics, chlorates
    - - Brown to black pigment, originate from neural crest
      - Disorders
        
        Neoplasia
        
        Benign: melanocytoma
        
        Malignant: malignant melanoma
        
        Too little (vitiligo and albinism)
        
        Too much (hyperpigmentation)
- - - - Abyssian
      - Shar Pei
    - - Chronic inflammation
        Production of SAA by liver
        SAA circulates in blood and taken up by macrophages
        SAA metabolized to amyloid and deposited in interstitum
  - - - Protein co-secreted with insulin by Beta cells
      - Seen in aged cats +/- diabetes mellitus