Norman E J, Thompson H, Mooney C T
Department of Veterinary Pathology, University of Glasgow Veterinary School.
Vet Rec. 1999 May 15;144(20):551-4. doi: 10.1136/vr.144.20.551.
The results of adrenocorticotropin (ACTH) stimulation and low-dose dexamethasone suppression tests (LDDST) were evaluated retrospectively in eight dogs with clinical signs of hyperadrenocorticism arising from functional adrenocortical tumours, and compared with the results from 12 dogs with confirmed pituitary-dependent hyperadrenocorticism (PDH). The post-ACTH cortisol concentration in the dogs with adrenocortical tumours ranged from 61 to 345-6 nmol/litre (median 251.5 nmol/litre) and they were within the reference range (150 to 450 nmol/litre) in five and unexpectedly low (< 150 nmol/litre) in three dogs. Both the basal and post-ACTH cortisol concentrations were significantly lower in the dogs with adrenocortical neoplasia than in the dogs with PDH. Eight hours after the LDDST, only two of six dogs with adrenocortical tumours had a cortisol concentration above 30 nmol/litre, and the median resting, three, and eight-hour cortisol concentrations were 31.5, 23.0, and 22.7 nmol/litre respectively. There was no significant cortisol suppression during the LDDST, although interpretation was complicated by the low cortisol concentrations, but two dogs showed a pattern of apparent suppression. Two dogs with adrenal tumours showed a diagnostically significant increase in 17-OH-progesterone concentration in response to ACTH although their cortisol concentrations did not increase greatly. These results differ from previous reports of the response of functional adrenal tumours to dynamic endocrine tests.
对8只因功能性肾上腺皮质肿瘤出现肾上腺皮质功能亢进临床症状的犬,回顾性评估促肾上腺皮质激素(ACTH)刺激试验和低剂量地塞米松抑制试验(LDDST)的结果,并与12只确诊为垂体依赖性肾上腺皮质功能亢进(PDH)的犬的结果进行比较。肾上腺皮质肿瘤犬的ACTH刺激后皮质醇浓度范围为61至345 - 6 nmol/升(中位数251.5 nmol/升),其中5只在参考范围(150至450 nmol/升)内,3只意外偏低(< 150 nmol/升)。肾上腺皮质肿瘤犬的基础皮质醇浓度和ACTH刺激后皮质醇浓度均显著低于PDH犬。LDDST 8小时后,6只肾上腺皮质肿瘤犬中只有2只的皮质醇浓度高于30 nmol/升,静息、3小时和8小时皮质醇浓度的中位数分别为31.5、23.0和22.7 nmol/升。LDDST期间虽无明显的皮质醇抑制,尽管低皮质醇浓度使结果解读复杂,但有2只犬呈现出明显抑制的模式。2只肾上腺肿瘤犬对ACTH反应时17 - OH - 孕酮浓度有诊断意义的升高,尽管其皮质醇浓度升高不大。这些结果与之前关于功能性肾上腺肿瘤对动态内分泌试验反应的报道不同。