Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Clínica Médica de Pequeños Animales, Hospital Escuela de Medicina Veterinaria-U. Endocrinología, Ciudad Autónoma de Buenos Aires, Argentina.
Normandie Univ, UNIROUEN, INSERM, DC2N, Rouen, France.
J Vet Intern Med. 2022 Jan;36(1):264-271. doi: 10.1111/jvim.16320. Epub 2021 Dec 3.
A 13-year-old Labrador retriever was diagnosed with Cushing's syndrome (CS) caused by primary bilateral nodular adrenocortical hyperplasia with adrenocorticotropic hormone (ACTH) expression. The pituitary origin of CS was ruled out by suppression of plasma ACTH concentration and absence of a proliferative lesion on histological evaluation of the pituitary gland using periodic acid-Schiff (PAS) staining, reticulin staining, and immunostaining for ACTH. A pheochromocytoma also was found at necropsy examination. On histological evaluation of both adrenal glands, at the junction of the fascicular and glomerular zones, multiple cell clusters distributed in both hyperplastic adrenal cortices expressed ACTH, whereas the pheochromocytoma cells did not. These results indicate that a disease similar to primary bilateral macronodular adrenocortical hyperplasia in humans also occurs in dogs, with intra-adrenocortical expression of ACTH, glucocorticoids excess, and clinical signs of CS. Therefore, the term ACTH-independent could be inappropriate in some cases of bilateral adrenocortical hyperplasia and suppressed plasma ACTH concentration in dogs.
一只 13 岁的拉布拉多猎犬被诊断患有库欣综合征（CS），病因是双侧结节性肾上腺皮质增生伴促肾上腺皮质激素（ACTH）表达。通过抑制血浆 ACTH 浓度和垂体组织学评估中缺乏增生性病变（使用过碘酸希夫（PAS）染色、网状染色和 ACTH 免疫染色）排除了 CS 的垂体起源。尸检还发现了嗜铬细胞瘤。在双侧肾上腺的组织学评估中，在束状带和肾小球带的交界处，分布在增生的肾上腺皮质中的多个细胞簇表达 ACTH，而嗜铬细胞瘤细胞则没有。这些结果表明，类似于人类的双侧大结节性肾上腺皮质增生的疾病也发生在狗中，表现为 ACTH 在内皮质中的表达、糖皮质激素过多和 CS 的临床症状。因此，在某些情况下，犬的双侧肾上腺皮质增生和抑制的血浆 ACTH 浓度可能不适用“ACTH 非依赖性”一词。
