Öz
Atlarda hipertiroidizm, zayıflama, taşipne, agresyon, iştahta değişim ve kaşeksi gibi çeşitli bulgulara sebep olan, genç atlarda nadir bir bozukluktur. Bu olgu sunumunda, tiroid adenomunun klinik tablosu ve tanısında kullanılan metotlar sunuldu. 3 yaşlı erkek Safkan atın dengeli besleme ve iştaha rağmen kilo kaybettiği ve agresifleştiği öğrenildi. İnspeksiyon sırasında larinksin kaudalinde, sol tarafta, palpe edilebilir, ağrısız ve hareketli bir kitle belirlendi. Daha ileri tanı için hemogram, serum biyokimyası, idrar dipstick analizi ve ultrasonografik muayenesi yapıldı. Serum biyokimyasında HDL, LDH, trigliserit, AST, direkt bilirubin, kreatin kinaz ve fT3 düzeyleri yüksek; TSH, fT4 ve ferritin düzeyleri ise düşük bulundu. Ultrasonografik muayenede ise sol tiroid dokusu 2.83 cm x 4.81 cm boyutundaydı. Aspiratın mikroskobik muayenesinde değişken boyutlarda küboidal epitel hücreleri ile çevrelenmiş sitoplazmadan zengin foliküller gözlendi. Bazı foliküllerde dilatasyon gözlenirken bazıları küçük hatta atrofikti. Sonuç olarak elde edilen yüksek fT3 ile düşük TSH düzeyleri, bezin aşırı aktif olduğunu, dolaşımdaki tiroid hormonu seviyesinin yüksek olduğu ve epifiz bezinin feedback mekanizması ile daha az TSH ürettiği, tüm bu durumun hipertiroidizmi gösterdiği gerçeği ile uyumluydu. Ayrıca tiroid adenomunun genç atlarda da görülebileceği, klinik semptomlara sebep olabileceği, ultrasonografik muayene, ince iğne aspirasyon tekniği ile alınan aspiratın mikroskobik muayenesi ile birlikte kapsamlı serum biyokimyası analizinin tanı için yeterli olduğu kanısına varıldı.
Anahtar Kelimeler
Kaynakça
- Bal, C., & Chawla, M. (2010). Hyperthyroidism and jaundice. Indian Journal of Nuclear Medicine: IJNM: The Official Journal of the Society of Nuclear Medicine, India, 25(4), 131. https://doi.org/10.4103/0972-3919.78244
- Breuhaus, B. A. (2011). Disorders of the equine thyroid gland. Veterinary Clinics: Equine Practice, 27(1), 115-128. https://doi.org/10.1016/j.cveq.2010.12.002
- Capen, C. (2002). Tumors of the endocrine glands. Tumors in domestic animals, 607-696. https://doi.org/10.1002/9780470376928.ch13
- Costello, J., Firshman, A. M., Brown, J. C., Maher, M., & Tadros, E. M. (2019). Response to thyrotropin-releasing hormone (TRH) in a horse with hyperthyroidism associated with a functional thyroid adenoma. The Canadian Veterinary Journal, 60(11), 1189. PMCID: PMC6805031.
- Duntas, L. H. (2002). Thyroid disease and lipids. Thyroid, 12(4), 287-293. https://doi.org/10.1089/10507250252949405
- Hines, M., Gay, C., & Talcott, T. (1997). Congenital hypothyroidism and dysmaturity syndrome of foals: diagnosis and possible risk factors. Proceedings 15th American College of Veterinary Internal Medicine, Lake Buena Vista. Lakewood (CO): ACVIM, 363-364.
- Kubota, K., Tamura, J., Kurabayashi, H., Shirakura, T., & Kobayashi, I. (1993). Evaluation of increased serum ferritin levels in patients with hyperthyroidism. The clinical investigator, 72(1), 26-29. https://doi.org/10.1007/BF00231112.
- Lumsden, J., Rowe, R., & Mullen, K. (1980). Hematology and biochemistry reference values for the light horse. Canadian Journal of Comparative Medicine, 44(1), 32. PMCID: PMC1320032.
- Mooney, C. T., & Murphy, D. (1995). Equine hypothyroidism: the difficulties of diagnosis. Equine Veterinary Education, 7(5), 242-245. https://doi.org/10.1111/j.2042-3292.1995.tb01237.x
- Ranka, R., & Mathur, R. (2003). Serum creatine phosphokinase in thyroid disorders. Indian Journal of Clinical Biochemistry, 18(1), 107-110. https://doi.org/10.1007/BF02867676.
- Sigal, G. A., Tavoni, T. M., Silva, B. M., Khalil-Filho, R., Brandão, L. G., Baracat, E. C., & Maranhão, R. C. (2020). Subclinical hyperthyroidism: status of the cholesterol transfers to HDL and other parameters related to lipoprotein metabolism in patients submitted to thyroidectomy for thyroid cancer. Frontiers in Endocrinology, 11, 176. https://doi.org/10.3389/fendo.2020.00176
- Sojka, J. E. (1995). Hypothyroidism in horses. The Compendium on continuing education for the practicing veterinarian (USA).
- Stockham, S. L. (1995). Interpretation of equine serum biochemical profile results. Veterinary clinics of North America: equine practice, 11(3), 391-414. https://doi.org/10.1016/S0749-0739(17)30307-3
- Tan, R. H., Davies, S., Crisman, M. V., Coyle, L., & Daniel, G. B. (2008). The use of propylthiouracil for treatment of hyperthyroidism in a horse. Journal of veterinary internal medicine, 22, 1253-1258. https://doi.org/10.1111/j.1939-1676.2008.0169.x
- Tsang, W., & Houlden, R. L. (2009). Amiodarone-induced thyrotoxicosis: a review. Canadian Journal of Cardiology, 25(7), 421-424. https://doi.org/10.1016/S0828-282X(09)70512-4
Öz
Hyperthyroidism in horses is a rare disorder in young horses that causes diverse findings such as weight loss, tachypnea, aggression, change in appetite and cachexia. In this report, the clinical manifestation and methods that used in the diagnosis of thyroid adenoma are presented. It was learned that a 3-year-old male Thoroughbred horse became aggressive and had been losing weight despite an adequate diet and appetite. During the inspection, a palpable, painless and moving mass was detected caudal to the larynx, on the left side. For further diagnosis, hemogram, serum biochemistry, urine dipstick analysis and ultrasonographic examination were performed. In serum biochemistry, high HDL, LDH, triglyceride, AST, direct bilirubin, creatine kinase and fT3; low TSH, fT4 and ferritin levels were determined. Ultrasonographic examination revealed that the left thyroid tissue was 2.83 cm x 4.81 cm in size. In the microscopic examination of the aspirate, it was observed that follicles were rich in cytoplasm and surrounded by cuboidal epithelial cells of varying sizes. Dilatation was observed in some follicles, while others were small or even atrophic. As a result, high fT3 and low TSH levels were consistent with the fact that the gland was overactive, the circulating thyroid hormone level was high, and the pineal gland produced less TSH by the feedback mechanism, all of which indicated hyperthyroidism. In addition, it was concluded that thyroid adenoma can also be seen in young horses, may cause clinical symptoms, ultrasonographic examination, microscopic examination of the aspirate and comprehensive serum biochemistry analysis are sufficient for diagnosis.
Anahtar Kelimeler
Fine needle aspiration Serum biochemistry Diagnosis Ultrasound
Kaynakça
- Bal, C., & Chawla, M. (2010). Hyperthyroidism and jaundice. Indian Journal of Nuclear Medicine: IJNM: The Official Journal of the Society of Nuclear Medicine, India, 25(4), 131. https://doi.org/10.4103/0972-3919.78244
- Breuhaus, B. A. (2011). Disorders of the equine thyroid gland. Veterinary Clinics: Equine Practice, 27(1), 115-128. https://doi.org/10.1016/j.cveq.2010.12.002
- Capen, C. (2002). Tumors of the endocrine glands. Tumors in domestic animals, 607-696. https://doi.org/10.1002/9780470376928.ch13
- Costello, J., Firshman, A. M., Brown, J. C., Maher, M., & Tadros, E. M. (2019). Response to thyrotropin-releasing hormone (TRH) in a horse with hyperthyroidism associated with a functional thyroid adenoma. The Canadian Veterinary Journal, 60(11), 1189. PMCID: PMC6805031.
- Duntas, L. H. (2002). Thyroid disease and lipids. Thyroid, 12(4), 287-293. https://doi.org/10.1089/10507250252949405
- Hines, M., Gay, C., & Talcott, T. (1997). Congenital hypothyroidism and dysmaturity syndrome of foals: diagnosis and possible risk factors. Proceedings 15th American College of Veterinary Internal Medicine, Lake Buena Vista. Lakewood (CO): ACVIM, 363-364.
- Kubota, K., Tamura, J., Kurabayashi, H., Shirakura, T., & Kobayashi, I. (1993). Evaluation of increased serum ferritin levels in patients with hyperthyroidism. The clinical investigator, 72(1), 26-29. https://doi.org/10.1007/BF00231112.
- Lumsden, J., Rowe, R., & Mullen, K. (1980). Hematology and biochemistry reference values for the light horse. Canadian Journal of Comparative Medicine, 44(1), 32. PMCID: PMC1320032.
- Mooney, C. T., & Murphy, D. (1995). Equine hypothyroidism: the difficulties of diagnosis. Equine Veterinary Education, 7(5), 242-245. https://doi.org/10.1111/j.2042-3292.1995.tb01237.x
- Ranka, R., & Mathur, R. (2003). Serum creatine phosphokinase in thyroid disorders. Indian Journal of Clinical Biochemistry, 18(1), 107-110. https://doi.org/10.1007/BF02867676.
- Sigal, G. A., Tavoni, T. M., Silva, B. M., Khalil-Filho, R., Brandão, L. G., Baracat, E. C., & Maranhão, R. C. (2020). Subclinical hyperthyroidism: status of the cholesterol transfers to HDL and other parameters related to lipoprotein metabolism in patients submitted to thyroidectomy for thyroid cancer. Frontiers in Endocrinology, 11, 176. https://doi.org/10.3389/fendo.2020.00176
- Sojka, J. E. (1995). Hypothyroidism in horses. The Compendium on continuing education for the practicing veterinarian (USA).
- Stockham, S. L. (1995). Interpretation of equine serum biochemical profile results. Veterinary clinics of North America: equine practice, 11(3), 391-414. https://doi.org/10.1016/S0749-0739(17)30307-3
- Tan, R. H., Davies, S., Crisman, M. V., Coyle, L., & Daniel, G. B. (2008). The use of propylthiouracil for treatment of hyperthyroidism in a horse. Journal of veterinary internal medicine, 22, 1253-1258. https://doi.org/10.1111/j.1939-1676.2008.0169.x
- Tsang, W., & Houlden, R. L. (2009). Amiodarone-induced thyrotoxicosis: a review. Canadian Journal of Cardiology, 25(7), 421-424. https://doi.org/10.1016/S0828-282X(09)70512-4
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Olgu sunumları |
| Yazarlar | |
| Yayımlanma Tarihi | 20 Mart 2024 |
| Gönderilme Tarihi | 7 Haziran 2022 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 13 Sayı: 1 |
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