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Polyglandular endocrinopathy type II (Schmidt's syndrome) in a Dobermann pinscher
Authors:J A Cartwright  J Stone  M Rick  M D Dunning
Institution:1. Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG;2. Pride Veterinary Centre, Derbyshire DE24 8HX;3. Diagnostic Center for Population and Animal Health, College of Veterinary Medicine, Michigan State University, Lansing, Michigan MI 48910‐8104, USA;4. School of Veterinary Medicine and Science, University of Nottingham, Leicestershire NG7 2RD
Abstract:A three‐year‐old, female neutered, Dobermann pinscher was presented for investigation of lethargy, episodic collapse, ataxia and myxoedema. Primary hypothyroidism and primary cortisol‐deficient hypoadrenocorticism were diagnosed based on history, physical examination and compatible hormonal analysis. Increased serum concentrations of thyroglobulin autoantibodies and 21‐hydroxylase autoantibodies indicated an immune‐mediated aetiology. The case was complicated by lymphadenopathy with hand‐mirror lymphocytes, classically identified in lymphoma. A polymerase chain reaction test for antigen receptor rearrangement indicated polyclonality and therefore reactive lymphadenopathy. The dog's clinical signs resolved following introduction of levothyroxine and prednisolone. Prioritising the problem‐based approach in this case facilitated the diagnosis of hypoadrenocorticism in addition to hypothyroidism due to the persistence of clinical signs despite thyroxine replacement. Importantly, atypical adrenal gland dysfunction was not misinterpreted as inadequate therapeutic response to thyroxine supplementation. The observation that polyglandular endocrinopathy type II can occur in dogs suggests that in dogs with a suboptimal response to treatment for hypothyroidism or hypoadrenocorticism comorbid endocrinopathies should be investigated.
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