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Jakie jest Twoje rozpoznanie? – cz. 3
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DALSZE BADANIA
Czynność nadnerczy
Wykonano test stymulacji ACTH – podstawowe stężenie kortyzolu (przed podaniem ACTH) wyniosło 113 ng/ml, a stężenie kortyzolu po stymulacji ACTH było wyższe niż 500 ng/ml. Nadmierna odpowiedź na podanie ACTH (kortyzol po stymulacji > 217 ng/ml) potwierdziła podejrzenie nadczynności kory nadnerczy.
Rozpoznanie nadczynności kory nadnerczy można było również postawić na podstawie wyniku testu hamowania niskimi dawkami deksametazonu – badanie bardziej czułe, ale mniej swoiste niż test stymulacji ACTH.
Czynność tarczycy
Określono stężenie wolnego T4 (9,6 pmol/l, RI: 7,7-47,6 pmol/l). Na podstawie prawidłowej wartości wykluczono niedoczynność tarczycy. Obniżenie całkowitego T4 wynikało z zespołu eutyreozy chorobowej.
Badania obrazowe
Wykonano badanie ultrasonograficzne jamy brzusznej, w którym zaobserwowano umiarkowane powiększenie obu nadnerczy, brak było zmian guzowatych. Wątroba była powiększona i hiperechogeniczna. Obraz ultrasonograficzny sugerował obecność ACTH-zależnej nadczynności kory nadnerczy.
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Galeria
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Zapisz się do bezpłatnego newslettera!
Bądź na bieżąco z nowościami z branży weterynaryjnej.
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Mogą zainteresować Cię również
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115
ALGORYTMY
POSTĘPOWANIA
w weterynarii
POSTĘPOWANIA
w weterynarii
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