In the literature review, we came across some similar case reports from other countries, but there is no reported PHA case from Turkey. In a study by Windsor et al.
5 in one of the three different cases they encountered, subcutaneous edema and severe diffuse anasarca type edema were noticed in the calf delivered by cesarean section and protrusion of the tongue was reported. Histopathological examination of the organs revealed that the heart, the thymus and the connective and adipose tissue were identified; however, pulmonary tissue, bronchial or tracheal tissue elements were not identified. In the second case, spongious edema was determined in the lower abdomen and no lung tissue was found in the thoracic cavity. In the third case, moderate anasarca-style edema due to accumulation of subcutaneous fluid was reported. Unlike the other two calves, there was rudimentary lung tissue in the thoracic cavity in this case. Histopathological examination of the tissues revealed significant thickening in the pleural surface, interalveolar and peribronchial areas and the bronchiolar submucosa of the lungs due to edema. There were diffuse hydropic changes in the renal tubular epithelium of the kidney. Alleaume et al.
9 reported a lamb with increased body weight, generalized subcutaneous fluid accumulation and significant effusions in the thoracic and abdominal cavities. The lamb diagnosed as 'fetal hydrops' was reported to have smaller lungs than normal. One of the lambs had a placenta that was severely edematous. Other than these findings, they did not report any other changes or lesions in the remaining organs. Monteagudo et al.
10 diagnosed „fetal anasarca‟ in lambs that demonstrated an overall increase in body weight and size. They reported that the fetus with edematous tongue had a fragile structure and there was an accumulation of yellow liquid in the body cavities. The authors stated that peripheral and internal lymph nodes were deficient in these cases. On microscopic examination, they detected edema in the soft skin tissues and there was no sample belonging to lymphoid tissue and the lymph nodes were missing; furthermore, they showed extramedullary hematopoiesis in the liver at various severities. In the case reported by Agerholm and Arnbjerg
8 they reported signs of pulmonary hypoplasia, interventricular septal defect, palatoschisis and bilateral cryptorchidism in a Belted Galloway breed calf. Svara et al.
3 reported multiple edematous cysts in the neck, hypoplastic lung and cardiac dilatation in two Cika breed calves diagnosed with PHA, but found no evidence of anomalies. In our case, the macroscopic and microscopic findings showed palatoschisis, atrial defect, ventricular septal defect and lung pathology as well as fetal hydrops; however, there was no cryptorchidism or significant abnormality in the other organs.
In conclusion, this is the first case reported from Turkey characterized by rarely observed anasarca type edema and other abnormalities among animals. We believe that this case will contribute to further researches on this issue and comprehensive investigations are needed to fully understand the etiology of PHA.
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