PubMed · 14132930
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P SATGE. 1964-05-09. [PRECOCIOUS PUBERTY].. https://pubmed.ncbi.nlm.nih.gov/14132930/
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The effects of trilostane, a 3beta-hydroxysteroid dehydrogenase inhibitor on basal cortisol concentrations and the results of ACTH stimulation tests in dogs with pituitary-dependent hyperadrenocorticism were investigated. In eight of nine dogs trilostane suppressed the concentration of cortisol below the lower limit of the reference range (<50 nmol/l) for a mean (sd) of 3.5 (2.3) hours during the day, but for no longer than 13 hours. In another 10 dogs, there was a clear difference between the post ACTH cortisol concentrations observed four and 24 hours after the administration of trilostane. Furthermore, in the six dogs whose clinical signs were poorly controlled the post-ACTH concentrations observed four and 24 hours after the administration of trilostane were always higher than the equivalent cortisol concentrations in the four dogs whose clinical signs were controlled. A short duration of drug action may be responsible for the failure of some dogs to respond adequately to once daily trilostane administration.
A 52-year-old woman presented with symptoms of virilization, which had been ongoing for 5 months. At the age of 34 years, she had a large abdominal carcinoid tumour removed. Twelve years later, she presented with Cushing's syndrome due to ectopic adrenocorticotrophic hormone (ACTH) production by carcinoid metastases localized in the right parametrium, fornix posterior and right diaphragm. Debulking laparotomy was performed followed by remission of hypercortisolism. Relapse of hypercortisolism followed 3 years later, and a second debulking laparotomy was performed including resection of the right ovary. In the following year, relapses of hypercortisolism were observed until bilateral adrenalectomy was performed. Laboratory evaluation revealed elevated serum levels of testosterone (23.0 nmol/l), androstenedione and 17-hydroxyprogesterone, and a serum estradiol (E2) level in the premenopausal range. The computerized tomography (CT) of the abdomen showed a large pelvic mass on the left side of the uterus without a recognizable left ovary. Treatment with a GnRH agonist (goserelin, 3.6 mg s.c., monthly) was initiated, resulting in normalization of the androgen levels. One year later, obstruction of the right ureter occurred due to progression of the pelvic metastases, thus a third debulking laparotomy with resection of the pelvic metastases including the left ovary was performed. The microscopic examination of the removed pelvic mass showed malignant carcinoid tissue with focal remnants of atrophic ovarian tissue. Two years after surgery, serum androgen levels are undetectable. We hypothesize that the high levels of ACTH at the site of the left ovary have induced androgen hypersecretion by steroid-producing cells in the ovary of our patient.
OBJECTIVE: To determine whether Scottish Terriers have higher serum alkaline phosphatase (ALP) activities and a higher prevalence of diseases commonly associated with high serum ALP activity than do dogs of other breeds. DESIGN: Retrospective case-control study. ANIMALS: 85 Scottish Terriers and 340 age-matched control dogs that were not Scottish Terriers. PROCEDURE: Medical records were reviewed, and data for year of evaluation, age, sex, breed, serum ALP activity, and final diagnosis were recorded. RESULTS: Scottish Terriers had a significantly higher mean serum ALP activity than did control dogs (1,520 U/L vs 306 U/L). Regardless of breed, dogs that had a disease commonly associated with high serum ALP activity had a significantly higher mean serum ALP activity than did dogs without such diseases (1,304 U/L vs 427 U/L). Scottish Terriers were 2.4 times as likely to have a disease commonly associated with high serum ALP activity than were control dogs, but Scottish Terriers with diseases commonly associated with high serum ALP activity had a significantly higher mean ALP activity than did control dogs with such diseases (2,073 U/L vs 909 U/L), and Scottish Terriers without such diseases had a significantly higher mean serum ALP activity than did control dogs without such diseases (1,349 U/L vs 228 U/L). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that Scottish Terriers have higher serum ALP activities than do dogs of other breeds. Although Scottish Terriers also have a higher prevalence of diseases associated with high serum ALP activity, this alone did not explain the higher mean serum ALP activity in the breed.