Case Report: Steroid-responsive immune-mediated thyroiditis in a young dog with multi-systemic pyogranulomatous inflammation

A 3-year-old neutered male Posavac Hound presented with rapidly progressive cervical swelling, respiratory distress, and systemic inflammation. Diagnostics confirmed severe hypothyroidism [total thyroxine (TT4) < 0.5 μg/dL, thyroid-stimulating hormone (TSH) 5.54 ng/dL], elevated thyroglobulin autoantibodies (TgAA 131%), hyperglobulinemia, hypoalbuminemia, and mild ionized hypercalcemia. Imaging showed bilateral thyroid enlargement with cavitated necrosis, pulmonary nodules, and lymphadenopathy. Cytology revealed pyogranulomatous inflammation without infectious organisms, and infectious disease screening was negative. Protein electrophoresis and immunofixation revealed elevated IgG4, suggesting immune-mediated dysregulation. The dog responded rapidly to prednisolone and thyroid hormone supplementation, with resolution of clinical signs and normalization of inflammatory markers by ~60 days. This report describes a unique case of immune-mediated thyroiditis with systemic inflammatory involvement that responded to steroids, emphasizing the importance of considering immune-mediated thyroiditis as a differential diagnosis for acute cervical neck swelling in a young dog with concurrent pulmonary involvement.