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Restored vision in a young dog following corticosteroid treatment of presumptive hypophysitis.

Abstract Hypophysitis is an umbrella term for a group of disorders involving inflammation of the pituitary gland. A rare occurrence in humans, hypophysitis can produce a range of clinical signs including (but not limited to) visual deficits and diabetes insipidus. Only five cases of canine hypophysitis exist in the literature, all presenting in mature dogs with no visual deficits and a grave outcome. This case report describes the clinical and advanced imaging features of blindness-inducing presumptive hypophysitis in a dog, which rapidly resolved with medical management.
PMID
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Authors

Mayor MeshTerms
Keywords

Central blindness

Hypophysitis

Insulin-like growth factor-1

Magnetic resonance imaging

Pituitary tumour

Standard Poodle

Journal Title bmc veterinary research
Publication Year Start




PMID- 28241874
OWN - NLM
STAT- MEDLINE
DA  - 20170228
DCOM- 20170313
LR  - 20170313
IS  - 1746-6148 (Electronic)
IS  - 1746-6148 (Linking)
VI  - 13
IP  - 1
DP  - 2017 Feb 28
TI  - Restored vision in a young dog following corticosteroid treatment of presumptive 
      hypophysitis.
PG  - 63
LID - 10.1186/s12917-017-0983-x [doi]
AB  - BACKGROUND: Hypophysitis is an umbrella term for a group of disorders involving
      inflammation of the pituitary gland. A rare occurrence in humans, hypophysitis
      can produce a range of clinical signs including (but not limited to) visual
      deficits and diabetes insipidus. Only five cases of canine hypophysitis exist in 
      the literature, all presenting in mature dogs with no visual deficits and a grave
      outcome. This case report describes the clinical and advanced imaging features of
      blindness-inducing presumptive hypophysitis in a dog, which rapidly resolved with
      medical management. CASE PRESENTATION: A 1-year-and-seven-month-old neutered male
      Standard Poodle presented with subacute blindness, ataxia, and
      polyuria/polydipsia (PUPD). Magnetic resonance imaging (MRI) detected a
      contrast-enhancing pituitary mass with perilesional oedema compromising the optic
      chiasm. Suspecting neoplasia, anti-inflammatory corticosteroid was commenced
      prior to radiation therapy planning. Complete resolution of neurological and
      visual deficits occurred within 12 days of starting steroid treatment. Repeated
      advanced imaging indicated macroscopic resolution of the lesion. An extended
      thyroid panel with insulin-like growth factor-1 analysis supported a diagnosis of
      hypophysitis. Resolution of PUPD was achieved with tapering courses of
      prednisolone and desmopressin; the dog has since been clinically normal for 14
      months and treatment-free for 11 months. CONCLUSIONS: To the authors' knowledge, 
      this is the first instance in which a canine pituitary mass has demonstrated
      long-term resolution with palliative medical treatment alone, alongside reversal 
      of associated blindness and presumptive diabetes insipidus. We suspect this
      lesion to be a form of hypophysitis, which should be included among differential 
      diagnoses for pituitary masses, and for subacute blindness in dogs. Where
      possible, we advocate biopsy-confirmation of hypophysitis prior to timely
      intervention with anti-inflammatory treatment.
FAU - Rzechorzek, Nina Marie
AU  - Rzechorzek NM
AD  - Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4SB,
      UK. nina.rzechorzek@ed.ac.uk.
AD  - Royal (Dick) School of Veterinary Studies and Roslin Institute, University of
      Edinburgh, Easter Bush Campus, Roslin, Midlothian, EH25 9RG, UK.
      nina.rzechorzek@ed.ac.uk.
FAU - Liuti, Tiziana
AU  - Liuti T
AD  - Royal (Dick) School of Veterinary Studies and Roslin Institute, University of
      Edinburgh, Easter Bush Campus, Roslin, Midlothian, EH25 9RG, UK.
FAU - Stalin, Catherine
AU  - Stalin C
AD  - The Neurology Service, Small Animal Hospital, School of Veterinary Medicine,
      University of Glasgow, Garscube Campus, Bearsden Road, Glasgow, G61 1QH, UK.
FAU - Marioni-Henry, Katia
AU  - Marioni-Henry K
AD  - Royal (Dick) School of Veterinary Studies and Roslin Institute, University of
      Edinburgh, Easter Bush Campus, Roslin, Midlothian, EH25 9RG, UK.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20170228
PL  - England
TA  - BMC Vet Res
JT  - BMC veterinary research
JID - 101249759
RN  - 0 (Adrenal Cortex Hormones)
SB  - IM
MH  - Adrenal Cortex Hormones/*therapeutic use
MH  - Animals
MH  - Dog Diseases/*drug therapy
MH  - Dogs
MH  - Hypophysitis/complications/drug therapy/*veterinary
MH  - Male
MH  - Treatment Outcome
MH  - Vision Disorders/drug therapy/etiology/*veterinary
PMC - PMC5330113
OTO - NOTNLM
OT  - *Central blindness
OT  - *Hypophysitis
OT  - *Insulin-like growth factor-1
OT  - *Magnetic resonance imaging
OT  - *Pituitary tumour
OT  - *Standard Poodle
EDAT- 2017/03/01 06:00
MHDA- 2017/03/14 06:00
CRDT- 2017/03/01 06:00
PHST- 2017/01/07 [received]
PHST- 2017/02/21 [accepted]
AID - 10.1186/s12917-017-0983-x [doi]
AID - 10.1186/s12917-017-0983-x [pii]
PST - epublish
SO  - BMC Vet Res. 2017 Feb 28;13(1):63. doi: 10.1186/s12917-017-0983-x.

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