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      Case report: Central-pituitary hypothyroidism concurrent with hyperadrenocorticism without pituitary macroadenoma in a Miniature Schnauzer dog

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          Abstract

          Multiple endocrine disorders are uncommon in veterinary medicine, and the disease combination is usually related to hypercortisolism or autoimmunity. Central-pituitary hypothyroidism, also refer to secondary hypothyroidism, can be caused by hypercortisolemic conditions and is well-recognized in human medicine. However, central hypothyroidism, including pituitary hypothyroidism, concurrent with hyperadrenocorticism, is rarely reported in veterinary medicine. A 7-year-old, intact female Miniature Schnauzer presented with generalized alopecia, scale, and pruritus and was diagnosed with superficial pyoderma and Malassezia dermatitis. Hormonal tests were performed, and the results indicated multiple endocrinopathies with a combination of non-adrenal dependent hyperadrenocorticism and central-pituitary hypothyroidism. Magnetic resonance imaging (7 T) and high-resolution research tomography positron emission tomography were performed to differentiate neuroendocrine tumors; however, no lesion was found in the hypothalamic to pituitary region. Hyperadrenocorticism was managed first to control endocrinopathy. After controlling hypercortisolism, a weak elevation of free thyroxine (T4) was revealed, whereas total T4 and thyroid-stimulating hormone (TSH) were still undetectable, and hypothyroidism management was added. About 9 months after the management, both endocrine diseases were well controlled, and clinical signs improved; however, serum TSH was unmeasured consistently. This case study describes a case of multiple endocrinopathies in a Miniature Schnauzer dog diagnosed with central-pituitary hypothyroidism concurrent with non-adrenal dependent hyperadrenocorticism without pituitary macroadenoma.

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          Most cited references41

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          High prevalence of pituitary adenomas: a cross-sectional study in the province of Liege, Belgium.

          Prevalence data are important for assessing the burden of disease on the health care system; data on pituitary adenoma prevalence are very scarce. The objective of the study was to measure the prevalence of clinically relevant pituitary adenomas in a well-defined population. This was a cross-sectional, intensive, case-finding study performed in three regions of the province of Liège, Belgium, to measure pituitary adenoma prevalence as of September 30, 2005. The study was conducted in specialist and general medical practitioner patient populations, referral hospitals, and investigational centers. Three demographically and geographically distinct districts of the province of Liège were delineated precisely using postal codes. Medical practitioners in these districts were recruited, and patients with pituitary adenomas under their care were identified. Diagnoses were confirmed after retrieval of clinical, hormonal, radiological, and pathological data; full demographic and therapeutic follow-up data were collected in all cases. Sixty-eight patients with clinically relevant pituitary adenomas were identified in a population of 71,972 individuals; the mean (+/- sd) prevalence was 94 +/- 19.3 cases per 100,000 population (95% confidence interval, 72.2 to 115.8). The group was 67.6% female and had a mean age at diagnosis of 40.3 yr; 42.6% had macroadenomas and 55.9% underwent surgery. Prolactinomas comprised 66% of the group, with the rest having nonsecreting tumors (14.7%), somatotropinomas (13.2%), or Cushing's disease (5.9%); 20.6% had hypopituitarism. The prevalence of pituitary adenomas in the study population (one case in 1064 individuals) was more than 3.5-5 times that previously reported. This increased prevalence may have important implications when prioritizing funding for research and treatment of pituitary adenomas.
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            Serum total thyroxine, total triiodothyronine, free thyroxine, and thyrotropin concentrations in dogs with nonthyroidal disease.

            To determine whether nonthyroidal disease of various causes and severity is associated with abnormalities in baseline serum concentrations of total thyroxine (T4), triiodothyronine (T3), free T4, or thyrotropin (thyroid-stimulating hormone [TSH]) in dogs believed to be euthyroid. Case-control study. 223 dogs with confirmed nonthyroidal diseases and presumptive normal thyroid function, and 150 clinically normal dogs. Serum total T4, total T3, free T4, and TSH concentrations were measured in dogs with confirmed nonthyroidal disease. Reference ranges for hormone concentrations were established on the basis of results from 150 clinically normal dogs. In dogs with nonthyroidal disease, median serum concentrations of total T4, total T3, and free T4 were significantly lower than those in clinically normal dogs. Median serum TSH concentration in sick dogs was significantly greater than that of clinically normal dogs. When stratified by severity of disease (ie, mild, moderate, and severe), dogs with severe disease had low serum concentrations of total T4, total T3, or free T4 more commonly than did dogs with mild disease. In contrast, serum TSH concentrations were more likely to remain within the reference range regardless of severity of disease. Results indicate that serum total T4, free T4, and total T3 concentrations may be low (ie, in the hypothyroid range) in dogs with moderate to severe nonthyroidal disease. Serum TSH concentrations are more likely to remain within the reference range in sick dogs.
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              Canine hypothyroidism: a review of aetiology and diagnosis.

              C T Mooney (2011)
              Hypothyroidism is recognised as an important endocrine disorder of dogs, and a frequent differential for numerous presenting complaints. Its diagnosis has never been straight forward as results suggestive of hypothyroidism can occur for a variety of reasons in dogs with normal thyroid function (euthyroid). As a consequence, the accurate investigation of hypothyroidism has been hindered by the potential inclusion of a number of cases not truly hypothyroid. In recent years, the development of newer diagnostic tests, e.g. free thyroxine, canine thyroid stimulating hormone, thyroglobulin autoantibodies, has significantly improved our ability to reliably differentiate hypothyroidism from other clinically similar disorders. This has led to a marked increase in our knowledge of the phenotypic, genotypic and aetiological aspects of this disorder in dogs.
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                Author and article information

                Contributors
                Journal
                Front Vet Sci
                Front Vet Sci
                Front. Vet. Sci.
                Frontiers in Veterinary Science
                Frontiers Media S.A.
                2297-1769
                25 September 2023
                2023
                : 10
                : 1257624
                Affiliations
                Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University , Cheongju, Republic of Korea
                Author notes

                Edited by: Muhammad Saqib, University of Agriculture, Faisalabad, Pakistan

                Reviewed by: Luca Giori, University of Tennessee, Knoxville, United States; Dong-In Jung, Gyeongsang National University, Republic of Korea

                *Correspondence: Byeong-Teck Kang, kangbt@ 123456chungbuk.ac.kr
                Article
                10.3389/fvets.2023.1257624
                10561239
                37818388
                91b076a8-cb8e-4dd2-bf3d-43c17bb82a4f
                Copyright © 2023 Chae, Yun, Koo, Lee, Yang, Kim and Kang.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 12 July 2023
                : 30 August 2023
                Page count
                Figures: 2, Tables: 1, Equations: 0, References: 41, Pages: 7, Words: 5017
                Funding
                Funded by: National Research Foundation of Korea, doi 10.13039/501100003725;
                Funded by: Ministry of Agriculture, Food and Rural Affairs, doi 10.13039/501100003624;
                The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean Government (MSIT), number 2021R1A2C1012058, and by the Korea Institute of Planning and Evaluation for Technology in Food, Agriculture, Forestry (IPET) through the Companion Animal Life Cycle Industry Technology Development Program, funded by the Ministry of Agriculture, Food and Rural Affairs (MAFRA) (322095-04).
                Categories
                Veterinary Science
                Case Report
                Custom metadata
                Comparative and Clinical Medicine

                central-pituitary hypothyroidism,hyperadrenocorticism,miniature schnauzer dog,multiple endocrinopathies,secondary hypothyroidism

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