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REDVET. Revista Electrónica de Veterinaria E-ISSN: 1695-7504 [email protected] Veterinaria Organización España Castillo, Víctor A.; Gámbaro, Germán; Sinatra, Verónica Toxoplasmosis as a cause of subacute thyroiditis in dogs REDVET. Revista Electrónica de Veterinaria, vol. VII, núm. 3, marzo, 2006, pp. 1-11 Veterinaria Organización Málaga, España Available in: http://www.redalyc.org/articulo.oa?id=63612698012 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative Revista Electrónica de Veterinaria REDVET ISSN 1695-7504 http://www.veterinaria.org/revistas/redvet Vol. VII, Nº 03, Marzo/2006 – http://www.veterinaria.org/revistas/redvet/n030306.html Toxoplasmosis as a cause of subacute thyroiditis in dogs (La toxoplasmosis como causa de tiroiditis subaguda en el perro) Castillo, Víctor A.: Unidad de Endocrinología y Enfermedades Metabólicas, Hospital Escuela, Facultad de Ciencias Veterinarias, UBA | Gámbaro, Germán | Sinatra Verónica: Área Clínica Médica de Pequeños Animales, Hospital Escuela, Facultad de Ciencias Veterinarias, UBA . Av Chorroarín 280 (1427), Ciudad de Buenos Aires, Argentina. E-mail: [email protected] Resúmen La tiroiditis subaguda es causada por la acción de agentes infecciosos. Clínicamente se observa bocio, disfonía y disfagia. Respecto a la función tiroidea, puede haber hipertirotoxinemia debida a la ruptura de folículos, en tanto que la concentración de TSH se mantiene normal y la captación de yodo está disminuída. El objetivo del presente trabajo fue investigar si la toxoplasmosis en perros puede afectar la morfología y función tiroidea. Se estudiaron 8 perros con toxoplasmosis comprobada (título de anticuerpos por aglutinación directa [AD] > 1/128). La palpación tiroidea impresionó bocio, confirmado por ecografía de la glándula. La medición de TSH fue normal, en tanto que la tiroxina resultó normal en 4 casos, elevada en 3 y disminuída en un caso, sin signos de tirotoxicosis ni de hipotiroidismo respectivamente. Los perros fueron tratados con clindanmicina (12,5 mg/kg oral cada 12 hs) por 30 días, siendo reevaluada la función y morfología tiroidea. En los 8 casos hubo remisión de los signos tiroideos y normalización de la tiroxina, al igual que la signología clínica. Se halló una correlación positiva entre título de anticuerpos AD y el volúmen tiroideo (r = 0,78, p<0,0002) y la tiroxina (r = 0,77, p<0,002). A los 6 meses del tratamiento, 2 casos evolucionaron hacia el hipotiroidismo, pese a haber estado eutiroideos durante el período agudo de la toxoplasmosis, siendo su causa la tiroiditis autoinmune de aparición ulterior (anticuerpo antitiroglobulina >160 %). Se concluye que la toxoplasmosis afecta la morfología tiroidea pudiéndose alterar su funcionamiento y desencadenar tiroiditis autoinmune en individuos predispuestos. Palabras Clave: bocio | tiroiditis | toxoplasmosis | tiroides. Abstract Subacute thyroiditis is caused by the action of infectious agents Clinically, goitre, dysphonia and dysphagia can be observed. Hyperthyroxinemia may be present, while thyrotropine (TSH) concentration stays normal and iodine uptake is reduced frequently. The objective of the present work was to investigate if toxoplasmosis in dogs can affect thyroid morphology and function. The study was conducted on eight dogs with proven high T. gondii titres (Direct aglutination <1/128). Goitre was confirmed by ultrasound of the gland. TSH measurement was normal, and thyroxine resulted normal in four cases, high in three and low in one case. The dogs were treated with clindamycin (12.5 mg/kg/twice a day PO) for 30 days. Positive correlations were found between the titre of antibodies and the thyroid volume (r = 0.78, P< 0.0002) and thyroxine (r = 0.77, P< 0.002). After six months treatment, two cases developed hypothyroidism due to autoimmune thyroiditis (thyroglobulin antibody >160%) in spite of being euthyroid during the acute period of toxoplasmosis. In conclusion, toxoplasmosis affects the thyroid morphology, being González Madariaga, Yisel; Castillo Alfonso, Orestes; Sánchez Alvarez, Carmen; Molina Martínez, Jose L: 1 Pizarro Espín, Arelia; Silveira Prado, Enrique A. Evaluación de la irritabilidad oftálmica de cremas cosméticas mediante un método in vitro en sustitución de la prueba en conejos. Revista Electrónica de Veterinaria REDVET ®, ISSN 1695-7504, Vol. VII, nº 03, Marzo/2006, Veterinaria.org ® - Comunidad Virtual Veterinaria.org ® - Veterinaria Organización S.L.® España. Mensual. Disponible en http://www.veterinaria.org/revistas/redvet y más específicamente en http://www.veterinaria.org/revistas/redvet/n030306.html Revista Electrónica de Veterinaria REDVET ISSN 1695-7504 http://www.veterinaria.org/revistas/redvet Vol. VII, Nº 03, Marzo/2006 – http://www.veterinaria.org/revistas/redvet/n030306.html able to alter its function with the development of autoimmune thyroiditis in susceptible individuals. Keywords: goitre | thyroiditis | toxoplasmosis | thyroids. INTRODUCTION Inflammation of the thyroid tissue is called thyroiditis. According to its aetiology, thyroiditis can be classified into autoimmune (autoimmune thyroiditis) and non autoimmune (including acute, subacute and chronic thyroiditis). In human each of these types can be characterized by its clinical development and the aetiological agents it is caused by (Reed Larsen et al., 1998). Subacute thyroiditis (ST) usually presents the following clinical signs: sudden mild to moderate pain in the upper and ventral third of the neck, corresponding to the laryngopharyngeal and tracheal area, dysphagia, dysphonia, and occasionally a cough, the latter also of sudden occurrence. A study of the thyroid function reveals a normal or slightly low concentration of thyrotropine (TSH), normal or slightly high levels of thyroxine (T4), caused by the rupture or loss of thyroid follicles, thus depleting any reserve of hormones stored in the colloid of the thyroid follicles. Iodine up-take is frequently reduced (hypocaptating), whereas on ultrasound there is an enhancement of the gland volume with mainly hypoechogenic images due to the inflammation (Reed Larsen et al., 1998). There are not report about subacute thyroiditis (not autoimmune) in dogs. Systemic viral infections or post vaccination reactions have been described as causes of ST. But the effects in thyroid function following natural infestation by the protozoa Toxoplasma gondii (T. gondii) and Neospora caninum have not been described in dogs. Stahl and Kaneda (1998a, b) describe that thyroid dysfunction occurs in mice experimentally infected with Toxoplasma gondii. Toxoplasmosis is a frequent infestation in dogs which are or have been occasionally fed on bovine raw meat (carry the oocysts) or in dogs which live with or near cats and are used to eating their faeces. Neuromuscular signs, such as ataxia, muscle atrophy or even paresis and convulsions, are typical of the acute phase of the disease (Taboada and Merchant, 1997). The diagnosis of this pathology is usually performed by the titre of antibodies against T. gondii. The purpose of the present study was to investigate whether the thyroid gland in dogs infected by T. gondii might be affected, both in its morphology and in its function and if such a disorder was permanent, transitory or if it might appear later, as an after-effect of toxoplasmosis. MATERIALS AND METHODS Study population The study was conducted on eight dogs weighing (median and range) 24 kg (18 -30 kg), 5 male and 3 female, which were derived to Endocrinology Unit from the Clinical Area of the School Hospital of the Veterinary School (UBA) with previous González Madariaga, Yisel; Castillo Alfonso, Orestes; Sánchez Alvarez, Carmen; Molina Martínez, Jose L: 2 Pizarro Espín, Arelia; Silveira Prado, Enrique A. Evaluación de la irritabilidad oftálmica de cremas cosméticas mediante un método in vitro en sustitución de la prueba en conejos. Revista Electrónica de Veterinaria REDVET ®, ISSN 1695-7504, Vol. VII, nº 03, Marzo/2006, Veterinaria.org ® - Comunidad Virtual Veterinaria.org ® - Veterinaria Organización S.L.® España. Mensual. Disponible en http://www.veterinaria.org/revistas/redvet y más específicamente en http://www.veterinaria.org/revistas/redvet/n030306.html Revista Electrónica de Veterinaria REDVET ISSN 1695-7504 http://www.veterinaria.org/revistas/redvet Vol. VII, Nº 03, Marzo/2006 – http://www.veterinaria.org/revistas/redvet/n030306.html diagnostic of toxoplasmosis. he dogs did not have received any treatment previously. The serological study for the diagnosis of toxoplasmosis (methodology developed by Instituto de Zoonosis "L. Pasteur", Buenos Aires, Arg.) was performed by the measurement of the titre of antibodies against T. gondii by direct agglutination method (DA, normal less than 1/54) with mercaptoethanol, which indicates current infection, and by indirect immunofluorescence (IIF, normal less than 1/128), which shows past infection or previous contact with protozoa. Should the result be negative with DA, the test would be repeated in 15 days, and a second negative result would refute the disease. The titre was repeated post treatment (30 days), and once more after 6 months of treatment (in this measurement the result is expressed as < 1/54 in normal cases and with the exact value in those cases above that value). The thyroid area was palpated and findings
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  • ATA/AACE Guidelines

    ATA/AACE Guidelines

    ATA/AACE Guidelines CLINICAL PRACTICE GUIDELINES FOR HYPOTHYROIDISM IN ADULTS: COSPONSORED BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND THE AMERICAN THYROID ASSOCIATION Jeffrey R. Garber, MD, FACP, FACE1,2*; Rhoda H. Cobin, MD, FACP, MACE3; Hossein Gharib, MD, MACP, MACE4; James V. Hennessey, MD, FACP2; Irwin Klein, MD, FACP5; Jeffrey I. Mechanick, MD, FACP, FACE, FACN6; Rachel Pessah-Pollack, MD6,7; Peter A. Singer, MD, FACE8; Kenneth A. Woeber, MD, FRCPE9 for the American Association of Clinical Endocrinologists and American Thyroid Association Taskforce on Hypothyroidism in Adults American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice are systematically developed statements to assist health-care professionals in medical decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied. These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes in this area are expected, periodic revisions are inevitable. We encourage medical professionals to use this information in conjunction with their best clinical judgment. The presented recommendations may not be appropriate in all situations. Any decision by practitioners to apply these guidelines must be made in light of local resources and individual patient circumstances. 988 989 CLINICAL PRACTICE GUIDELINES FOR HYPOTHYROIDISM IN ADULTS: COSPONSORED BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND THE AMERICAN THYROID ASSOCIATION Jeffrey R. Garber, MD, FACP, FACE1,2*; Rhoda H. Cobin, MD, FACP, MACE3; Hossein Gharib, MD, MACP, MACE4; James V. Hennessey, MD, FACP2; Irwin Klein, MD, FACP5; Jeffrey I. Mechanick, MD, FACP, FACE, FACN6; Rachel Pessah-Pollack, MD6,7; Peter A.