Frank L A, Henry G A, Whittemore J C, Enders B D, Mawby D I, Rohrbach B W
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN.
J Vet Intern Med. 2015 Jan;29(1):193-9. doi: 10.1111/jvim.12500. Epub 2014 Nov 20.
Atypical hyperadrenocorticism (AHAC) is considered when dogs have clinical signs of hypercortisolemia with normal hyperadrenocorticism screening tests.
HYPOTHESIS/OBJECTIVES: To compare cortisol concentrations and adrenal gland size among dogs with pituitary-dependent hyperadrenocorticism (PDH), atypical hyperadrenocorticism (AHAC), and healthy controls.
Ten healthy dogs, 7 dogs with PDH, and 8 dogs with AHAC.
Dogs were prospectively enrolled between November 2011 and January 2013. Dogs were diagnosed with PDH or AHAC based on clinical signs and positive screening test results (PDH) or abnormal extended adrenal hormone panel results (AHAC). Transverse adrenal gland measurements were obtained by abdominal ultrasound. Hourly mean cortisol (9 samplings), sum of hourly cortisol measurements and adrenal gland sizes were compared among the 3 groups.
Hourly (control, 1.4 ± 0.6 μg/dL; AHAC, 2.9 ± 1.3; PDH, 4.3 ± 1.5) (mean, SD) and sum (control, 11.3 ± 3.3; AHAC, 23.2 ± 7.7; PDH, 34.7 ± 9.9) cortisol concentrations differed significantly between the controls and AHAC (P < .01) and PDH (P < .01) groups. Hourly (P < .01) but not sum (P = .27) cortisol concentrations differed between AHAC and PDH dogs. Average transverse adrenal gland diameter of control dogs (5.3 ± 1.2 mm) was significantly less than dogs with PDH (6.4 ± 1.4; P = .02) and AHAC (7.2 ± 1.5; P < .01); adrenal gland diameter did not differ (P = .18) between dogs with AHAC and PDH.
Serum cortisol concentrations in dogs with AHAC were increased compared to controls but less than dogs with PDH, while adrenal gland diameter was similar between dogs with AHAC and PDH. These findings suggest cortisol excess could contribute to the pathophysiology of AHAC.
当犬出现高皮质醇血症的临床症状且肾上腺皮质功能亢进筛查试验结果正常时，可考虑非典型肾上腺皮质功能亢进（AHAC）。
假设/目的：比较垂体依赖性肾上腺皮质功能亢进（PDH）、非典型肾上腺皮质功能亢进（AHAC）犬及健康对照犬的皮质醇浓度和肾上腺大小。
10只健康犬、7只PDH犬和8只AHAC犬。
2011年11月至2013年1月前瞻性纳入犬只。根据临床症状和筛查试验阳性结果（PDH）或肾上腺激素扩展检测结果异常（AHAC）诊断PDH或AHAC犬。通过腹部超声测量肾上腺横径。比较三组犬的每小时平均皮质醇（9次采样）、每小时皮质醇测量值总和及肾上腺大小。
每小时皮质醇浓度（对照组，1.4±0.6μg/dL；AHAC组，2.9±1.3；PDH组，4.3±1.5）（均值，标准差）及总和（对照组，11.3±3.3；AHAC组，23.2±7.7；PDH组，34.7±9.9）在对照组与AHAC组（P<.01）及PDH组（P<.01）之间差异显著。AHAC犬与PDH犬每小时皮质醇浓度有差异（P<.01），但总和无差异（P = .27）。对照犬肾上腺平均横径（5.3±1.2mm）显著小于PDH犬（6.4±1.4；P = .02）和AHAC犬（7.2±1.5；P<.01）；AHAC犬与PDH犬的肾上腺直径无差异（P = .18）。
与对照组相比，AHAC犬血清皮质醇浓度升高，但低于PDH犬，而AHAC犬与PDH犬的肾上腺直径相似。这些发现提示皮质醇过量可能参与AHAC的病理生理过程。
