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经蝶窦垂体切除术治疗犬垂体生长激素腺瘤继发的过度生长激素血症。

Transsphenoidal hypophysectomy for the treatment of hypersomatotropism secondary to a pituitary somatotroph adenoma in a dog.

机构信息

Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK.

Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, UK.

出版信息

J Vet Intern Med. 2024 Jan-Feb;38(1):351-357. doi: 10.1111/jvim.16929. Epub 2023 Nov 2.

Abstract

Pituitary-dependent hypersomatotropism is rarely diagnosed in dogs and surgical treatment is not reported. A 6-year-10-month male neutered Patterdale Terrier presented with polyuria, polydipsia, progressive pharyngeal stertor, excessive hair growth and widened facial features and paws. Serum insulin-like growth factor-1 concentration via radioimmunoassay was consistent with hypersomatotropism (1783 ng/mL). A pituitary mass was identified on magnetic resonance and computed tomography imaging. Six weeks later, glucosuria, starved hyperglycemia and serum fructosamine above the reference range (467.6 μmol/L, RI 177-314) were documented, consistent with diabetes mellitus. Transsphenoidal hypophysectomy was performed under general anesthesia without complications. Pituitary histopathology identified an acidophil neoplasm, with positive immunostaining for growth hormone. Postoperatively, there was rapid resolution of clinical, biochemical and morphologic changes of hypersomatotropism with persistence of diabetes mellitus. This case demonstrates successful resolution of hypersomatotropism with ongoing diabetes mellitus in a dog after surgical treatment by transsphenoidal hypophysectomy.

摘要

垂体依赖性过度生长激素分泌症在犬中很少被诊断,也没有报道过手术治疗。一只 6 岁 10 个月大的已去势雄性帕特大勒梗表现出多尿、多饮、进行性咽部喘鸣、过度生长毛发以及面部和爪子变宽。放射免疫法检测血清胰岛素样生长因子-1 浓度与过度生长激素分泌一致(1783ng/ml)。磁共振成像和计算机断层扫描显示垂体有肿块。6 周后,出现糖尿、饥饿性高血糖和血清果糖胺高于参考范围(467.6μmol/L,RI 177-314),符合糖尿病的特征。在全身麻醉下进行经蝶窦垂体切除术,没有出现并发症。垂体组织病理学发现嗜酸性细胞瘤,生长激素免疫染色阳性。术后,过度生长激素的临床、生化和形态学变化迅速得到解决,但糖尿病仍持续存在。该病例表明,经蝶窦垂体切除术治疗后,犬的过度生长激素分泌症得到成功解决,但同时仍存在糖尿病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/452a/10800194/53be43e8538f/JVIM-38-351-g004.jpg

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