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Antigen Concentrations as an Indicator of Clinical Remission and Disease Relapse in Cats with Histoplasmosis.
J Vet Intern Med. 2016 Jul; 30(4):1065-73.JV

Abstract

BACKGROUND

Treatment monitoring is subjective and disease relapse is common in cats with histoplasmosis. The Histoplasma antigen enzyme immunoassay (EIA) is a noninvasive test used for determining disease remission and detecting disease relapse in humans with histoplasmosis. The utility of the antigen EIA for these purposes in cats remains unknown.

HYPOTHESIS/OBJECTIVES

Those Histoplasma antigen concentrations in urine and serum would decline with antifungal treatment and that antigen elimination would be an indicator of clinical remission in cats with histoplasmosis treated with antifungal treatment.

ANIMALS

Fifteen client-owned cats with histoplasmosis.

METHODS

Masked observational study. Cats were monitored monthly during antifungal treatment. Time of clinical remission and serum and urine antigen elimination were determined for each cat.

RESULTS

Twelve of 15 cats achieved clinical remission. At the time of diagnosis, antigen was detectable in urine in 14/15 (93%) cats and in serum in 11/15 (73%) cats. Both serum (P < .0005) and urine (P < .0001) antigen concentrations significantly decreased over time with effective treatment. Antigen elimination was sensitive [urine, 90.0% (95% CI 72.3-97.4%); serum, 90.4% (68.2-98.3%)] but less specific [urine, 64.6% (51.7-75.8%); serum, 52.1% (37.4-66.5%)] for disease remission. Urine antigen was positive in both cats and serum antigen was positive in 1 cat at the time of disease relapse.

CONCLUSIONS AND CLINICAL IMPORTANCE

Measurement of Histoplasma antigen in urine and serum might be useful tests for determining disease remission and relapse in cats with histoplasmosis. Further research is needed to investigate the importance of low-level antigenemia and antigenuria.

Authors+Show Affiliations

Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, OK.Department of Veterinary Pathobiology, Oklahoma State University, Stillwater, OK.MiraVista Diagnostics, Indianapolis, IN.Department of Statistics, Oklahoma State University, Stillwater, OK.MiraVista Diagnostics, Indianapolis, IN.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27158815

Citation

Hanzlicek, A S., et al. "Antigen Concentrations as an Indicator of Clinical Remission and Disease Relapse in Cats With Histoplasmosis." Journal of Veterinary Internal Medicine, vol. 30, no. 4, 2016, pp. 1065-73.
Hanzlicek AS, Meinkoth JH, Renschler JS, et al. Antigen Concentrations as an Indicator of Clinical Remission and Disease Relapse in Cats with Histoplasmosis. J Vet Intern Med. 2016;30(4):1065-73.
Hanzlicek, A. S., Meinkoth, J. H., Renschler, J. S., Goad, C., & Wheat, L. J. (2016). Antigen Concentrations as an Indicator of Clinical Remission and Disease Relapse in Cats with Histoplasmosis. Journal of Veterinary Internal Medicine, 30(4), 1065-73. https://doi.org/10.1111/jvim.13962
Hanzlicek AS, et al. Antigen Concentrations as an Indicator of Clinical Remission and Disease Relapse in Cats With Histoplasmosis. J Vet Intern Med. 2016;30(4):1065-73. PubMed PMID: 27158815.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antigen Concentrations as an Indicator of Clinical Remission and Disease Relapse in Cats with Histoplasmosis. AU - Hanzlicek,A S, AU - Meinkoth,J H, AU - Renschler,J S, AU - Goad,C, AU - Wheat,L J, Y1 - 2016/05/09/ PY - 2015/11/30/received PY - 2016/02/29/revised PY - 2016/04/18/accepted PY - 2016/5/10/entrez PY - 2016/5/10/pubmed PY - 2018/2/6/medline KW - Feline KW - Fungal KW - Histoplasma KW - Mycosis SP - 1065 EP - 73 JF - Journal of veterinary internal medicine JO - J Vet Intern Med VL - 30 IS - 4 N2 - BACKGROUND: Treatment monitoring is subjective and disease relapse is common in cats with histoplasmosis. The Histoplasma antigen enzyme immunoassay (EIA) is a noninvasive test used for determining disease remission and detecting disease relapse in humans with histoplasmosis. The utility of the antigen EIA for these purposes in cats remains unknown. HYPOTHESIS/OBJECTIVES: Those Histoplasma antigen concentrations in urine and serum would decline with antifungal treatment and that antigen elimination would be an indicator of clinical remission in cats with histoplasmosis treated with antifungal treatment. ANIMALS: Fifteen client-owned cats with histoplasmosis. METHODS: Masked observational study. Cats were monitored monthly during antifungal treatment. Time of clinical remission and serum and urine antigen elimination were determined for each cat. RESULTS: Twelve of 15 cats achieved clinical remission. At the time of diagnosis, antigen was detectable in urine in 14/15 (93%) cats and in serum in 11/15 (73%) cats. Both serum (P < .0005) and urine (P < .0001) antigen concentrations significantly decreased over time with effective treatment. Antigen elimination was sensitive [urine, 90.0% (95% CI 72.3-97.4%); serum, 90.4% (68.2-98.3%)] but less specific [urine, 64.6% (51.7-75.8%); serum, 52.1% (37.4-66.5%)] for disease remission. Urine antigen was positive in both cats and serum antigen was positive in 1 cat at the time of disease relapse. CONCLUSIONS AND CLINICAL IMPORTANCE: Measurement of Histoplasma antigen in urine and serum might be useful tests for determining disease remission and relapse in cats with histoplasmosis. Further research is needed to investigate the importance of low-level antigenemia and antigenuria. SN - 1939-1676 UR - https://www.unboundmedicine.com/medline/citation/27158815/Antigen_Concentrations_as_an_Indicator_of_Clinical_Remission_and_Disease_Relapse_in_Cats_with_Histoplasmosis_ L2 - https://doi.org/10.1111/jvim.13962 DB - PRIME DP - Unbound Medicine ER -