3例猫医源性肾上腺皮质功能亢进病例报告

Case report of three feline iatrogenic hyperadrenocorticism

猫医源性肾上腺皮质功能亢进(iatrogenic hyperadrenocorticism, IHAC)在兽医临床中少有报道。为了加深临床兽医对该疾病的认识,笔者对3例经病史调查、临床症状及促肾上腺皮质激素(ACTH)刺激试验确诊为IHAC的病例进行了回顾性分析。结果表明:3例患猫均存在长期/大量使用糖皮质激素的用药史,并出现符合IHAC的临床症状;血常规及血液生化指标无特异性变化;B型超声波检查肾上腺未见明显异常;ACTH刺激后皮质醇浓度均小于50 ng/mL。说明猫虽然对糖皮质激素相关毒副作用具有高度抵抗力,但仍可能发生IHAC,因此在猫身上应谨慎使用糖皮质激素。

Feline iatrogenic hyperadrenocorticism(IHAC) was rarely reported in veterinary clinics. In order to deepen the clinical veterinarian’s understanding of the disease, the author retrospectively analyzed three cases diagnosed as IHAC by history investigation, clinical symptoms and adrenocorticotropic hormone(ACTH) stimulation test. The results showed that all the cats in the three cases had a history of long-term/heavy use of glucocorticoids, and had clinical symptoms consistent with IHAC;there were no specific changes in blood routine and blood biochemical indexes;B-type ultrasonography showed no obvious abnormality in the adrenal glands;cortisol concentrations were less than 50 ng/mL after ACTH stimulation. The results suggested that although cats were highly resistant to glucocorticoid-related side effects, IHAC may still occur, so glucocorticoids should be used with caution in cats.