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Serum and urine Blastomyces antigen concentrations as markers of clinical remission in dogs treated for systemic blastomycosis.
J Vet Intern Med. 2014 Mar-Apr; 28(2):305-10.JV

Abstract

BACKGROUND

Serum and urine Blastomyces antigen concentrations can be used to diagnose blastomycosis in dogs.

OBJECTIVES

Blastomyces antigen concentrations correlate with clinical remission in dogs during antifungal treatment, and detect disease relapse after treatment discontinuation.

ANIMALS

21 dogs with newly diagnosed blastomycosis monitored until clinical remission (Treatment Phase), and 27 dogs monitored over 1 year from the time of antifungal discontinuation or until clinical relapse (After Treatment Phase).

METHODS

Prospective study. Dogs were monitored monthly during treatment and every 3 months after treatment discontinuation, with a complete history, physical exam, chest radiographs, and ocular exam. Urine and serum Blastomyces antigen concentrations were measured at each visit using a quantitative enzyme immunoassay.

RESULTS

At enrollment in the Treatment Phase, Blastomyces antigen was positive in all 21 urine samples (100% sensitivity; 95% CI 85-100%), and in 18 of 20 serum samples (90% sensitivity; 95% CI 70-97%). At 2-4 months of treatment, urine antigen was more sensitive for clinically detectable disease (82%; CI 60-94%) than serum antigen (18%; CI 6-41%). The sensitivity of the urine test for clinical relapse was 71% (CI 36-92%), with close to 100% specificity (CI 84-100%) during after treatment surveillance in this population.

CONCLUSIONS

Urine Blastomyces antigen testing has high sensitivity for active disease at the time of diagnosis and during treatment, and moderate sensitivity but high specificity for clinical relapse. Urine testing should be useful at the time of diagnosis, when treatment discontinuation is being considered, and anytime there is poor clinical response or suspicion of relapse.

Authors+Show Affiliations

Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24495193

Citation

Foy, D S., et al. "Serum and Urine Blastomyces Antigen Concentrations as Markers of Clinical Remission in Dogs Treated for Systemic Blastomycosis." Journal of Veterinary Internal Medicine, vol. 28, no. 2, 2014, pp. 305-10.
Foy DS, Trepanier LA, Kirsch EJ, et al. Serum and urine Blastomyces antigen concentrations as markers of clinical remission in dogs treated for systemic blastomycosis. J Vet Intern Med. 2014;28(2):305-10.
Foy, D. S., Trepanier, L. A., Kirsch, E. J., & Wheat, L. J. (2014). Serum and urine Blastomyces antigen concentrations as markers of clinical remission in dogs treated for systemic blastomycosis. Journal of Veterinary Internal Medicine, 28(2), 305-10. https://doi.org/10.1111/jvim.12306
Foy DS, et al. Serum and Urine Blastomyces Antigen Concentrations as Markers of Clinical Remission in Dogs Treated for Systemic Blastomycosis. J Vet Intern Med. 2014 Mar-Apr;28(2):305-10. PubMed PMID: 24495193.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum and urine Blastomyces antigen concentrations as markers of clinical remission in dogs treated for systemic blastomycosis. AU - Foy,D S, AU - Trepanier,L A, AU - Kirsch,E J, AU - Wheat,L J, Y1 - 2014/02/03/ PY - 2013/07/26/received PY - 2013/11/08/revised PY - 2013/12/17/accepted PY - 2014/2/6/entrez PY - 2014/2/6/pubmed PY - 2015/2/20/medline KW - Canine KW - Monitoring KW - Systemic fungal infection SP - 305 EP - 10 JF - Journal of veterinary internal medicine JO - J Vet Intern Med VL - 28 IS - 2 N2 - BACKGROUND: Serum and urine Blastomyces antigen concentrations can be used to diagnose blastomycosis in dogs. OBJECTIVES: Blastomyces antigen concentrations correlate with clinical remission in dogs during antifungal treatment, and detect disease relapse after treatment discontinuation. ANIMALS: 21 dogs with newly diagnosed blastomycosis monitored until clinical remission (Treatment Phase), and 27 dogs monitored over 1 year from the time of antifungal discontinuation or until clinical relapse (After Treatment Phase). METHODS: Prospective study. Dogs were monitored monthly during treatment and every 3 months after treatment discontinuation, with a complete history, physical exam, chest radiographs, and ocular exam. Urine and serum Blastomyces antigen concentrations were measured at each visit using a quantitative enzyme immunoassay. RESULTS: At enrollment in the Treatment Phase, Blastomyces antigen was positive in all 21 urine samples (100% sensitivity; 95% CI 85-100%), and in 18 of 20 serum samples (90% sensitivity; 95% CI 70-97%). At 2-4 months of treatment, urine antigen was more sensitive for clinically detectable disease (82%; CI 60-94%) than serum antigen (18%; CI 6-41%). The sensitivity of the urine test for clinical relapse was 71% (CI 36-92%), with close to 100% specificity (CI 84-100%) during after treatment surveillance in this population. CONCLUSIONS: Urine Blastomyces antigen testing has high sensitivity for active disease at the time of diagnosis and during treatment, and moderate sensitivity but high specificity for clinical relapse. Urine testing should be useful at the time of diagnosis, when treatment discontinuation is being considered, and anytime there is poor clinical response or suspicion of relapse. SN - 1939-1676 UR - https://www.unboundmedicine.com/medline/citation/24495193/Serum_and_urine_Blastomyces_antigen_concentrations_as_markers_of_clinical_remission_in_dogs_treated_for_systemic_blastomycosis_ L2 - https://doi.org/10.1111/jvim.12306 DB - PRIME DP - Unbound Medicine ER -