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Hiperadrenocorticismo atípico em cães
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Abstract(s)
O hiperadrenocorticismo (HAC) é das endocrinopatias mais frequentes em cães idosos. Quando os sinais clínicos e achados no exame físico são compatíveis com a doença, a realização de exames complementares é necessária para se fazer o diagnóstico definitivo. Os resultados do hemograma, análises bioquímicas e análise de urina podem suportar o diagnóstico juntamente com os resultados de testes hormonais, como o teste de estimulação com a hormona adrenocorticotrófica (ACTH), e o teste de supressão com baixas doses de dexametasona (LDDST). Estes testes baseiamse na medição de cortisol sérico. No entanto, em certos cães, apesar da presença de sinais clínicos compatíveis com HAC, os resultados dos testes hormonais podem encontrar-se dentro dos parâmetros de normalidade. Nestes casos, deve-se suspeitar de hiperadrenocorticismo atípico (AHAC), pois apesar das concentrações de cortisol plasmático se encontrarem dentro dos valores normais, pode observar-se um aumento da concentração de hormonas sexuais e / ou de precursores esteroides, nomeadamente de 17-hidroxiprogesterona (17OHP). Estes casos são um desafio diagnóstico dada a dificuldade de confirmação laboratorial do mesmo.
Hyperadrenocorticism (HAC) is one of the most frequent endocrine diseases of older dogs. When the clinical signs and findings on physical examination are consistent with the pathology, the execution of complementary exams is required to complete the diagnosis. The results of a blood count, biochemical analysis and urinalysis can support the diagnosis along with the execution of hormonal tests such as the stimulation test with adrenocorticotropic hormone (ACTH) or the low doses of dexamethasone suppression test (LDDST). However, in some dogs, despite the presence of clinical signs consistent with HAC, the results of the hormone tests are within normal parameters. In these cases, atypical hyperadrenocorticism (AHAC) can be suspected. Despite plasma cortisol concentrations being in the normal range, may be observed an increase in the concentration of sex hormones and / or precursors of cortisol synthesis, namely 17-hydroxyprogesterone (17OHP). These cases are a diagnostic challenge due to the difficulty of laboratory confirmation.
Hyperadrenocorticism (HAC) is one of the most frequent endocrine diseases of older dogs. When the clinical signs and findings on physical examination are consistent with the pathology, the execution of complementary exams is required to complete the diagnosis. The results of a blood count, biochemical analysis and urinalysis can support the diagnosis along with the execution of hormonal tests such as the stimulation test with adrenocorticotropic hormone (ACTH) or the low doses of dexamethasone suppression test (LDDST). However, in some dogs, despite the presence of clinical signs consistent with HAC, the results of the hormone tests are within normal parameters. In these cases, atypical hyperadrenocorticism (AHAC) can be suspected. Despite plasma cortisol concentrations being in the normal range, may be observed an increase in the concentration of sex hormones and / or precursors of cortisol synthesis, namely 17-hydroxyprogesterone (17OHP). These cases are a diagnostic challenge due to the difficulty of laboratory confirmation.
Description
Keywords
Hiperadrenocorticismo atípico Hormonas sexuais Precursores hormonais 17-hidroxiprogesterona Cão Atypical hyperadrenocorticism Sex hormones Steroid precursors 17-hydroxyprogesterone Dog