Blood Carboxyhemoglobin Concentrations as a Diagnostic Biomarker of Hemolytic Anemias in Cats

IF 2.1 2区农林科学 Q1 VETERINARY SCIENCES

Journal of Veterinary Internal Medicine Pub Date : 2025-03-08 DOI:10.1111/jvim.70058

Ran Nivy, Gila Abells Sutton, Yaron Bruchim

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Abstract

Background

Endogenous carboxyhemoglobin (COHb) production is a byproduct of hemoglobin metabolism.

Hypothesis

Blood carboxyhemoglobin concentrations are higher in cats with hemolytic anemia (HA).

Animals

Twenty cats with HA, 29 cats with non-HA, and 22 controls were prospectively followed.

Methods

Blood tests were performed upon admission. The Mann–Whitney and Kruskal–Wallis tests were used for comparisons. Receiver-operating characteristic (ROC) analyses tested COHb as a marker of HA or survival.

Results

The HA group included 17 cats with immune-mediated HA and 3 with Heinz body (HB) anemia. In the non-HA group, leading diagnoses included kidney disease (n = 14), acute/chronic blood loss (n = 11) and pancytopenia (n = 3). Carboxyhemoglobin concentrations (median [IQR]) significantly differed between cats with HA (5.55% [1.9]) and cats with non-HA (1.9% [0.7]) or controls (1.9% [0.67]; p < 0.001 for both), but not between the last two groups (p = 0.6). Among 13 nonanemic stray cats with significant HB formation, the median (IQR) COHb concentration was 6.1% (1.2). The area under the ROC curve for COHb as a predictor of HA among all anemic cats was 0.996 (95% CI, 0.985–1), with an optimal cut-off point of 2.95% yielding a sensitivity/specificity of 95% (95% CI, 76%–99%) and 100% (95% CI, 88%–100%), respectively. Survival and COHb concentrations were not associated in either group.

Conclusions and Clinical Importance

COHb proved a useful ancillary test in cats with suspected HA. Nevertheless, endogenous COHb production occurs with the absorption of large hematomas, not studied herein, or during hemolysis irrespective of anemia. These caveats must be considered when applying the present findings to the clinical and research setting.

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血碳氧血红蛋白浓度作为猫溶血性贫血的诊断性生物标志物

内源性碳氧血红蛋白（COHb）的产生是血红蛋白代谢的副产物。假设患有溶血性贫血（HA）的猫血中碳氧血红蛋白浓度较高。20只HA猫，29只非HA猫和22只对照猫进行前瞻性随访。方法入院时进行血液检查。使用Mann-Whitney和Kruskal-Wallis测试进行比较。受试者工作特征（ROC）分析测试COHb作为血凝素或生存的标志。结果HA组17只猫患有免疫介导的HA， 3只猫患有亨氏体（HB）贫血。在非ha组中，主要诊断包括肾脏疾病（n = 14），急性/慢性失血（n = 11）和全血细胞减少症（n = 3）。血凝素组猫（5.55%[1.9]）与非血凝素组猫（1.9%[0.7]）或对照组猫（1.9%[0.67]）之间的羧血红蛋白浓度（中位数[IQR]）差异显著；P < 0.001)，但后两组之间没有差异（P = 0.6）。在13只有明显HB形成的非贫血流浪猫中，COHb浓度中位数（IQR）为6.1%（1.2）。COHb作为所有贫血猫血凝素预测因子的ROC曲线下面积为0.996 (95% CI, 0.985-1)，最佳截断点为2.95%，敏感性/特异性分别为95% （95% CI, 76%-99%）和100% （95% CI, 88%-100%）。两组患者的生存率和COHb浓度均无相关性。结论和临床意义：COHb在疑似HA的猫中是一种有用的辅助检测。然而，内源性COHb的产生伴随着大血肿的吸收，或溶血过程中发生，与贫血无关，本文未对此进行研究。在将目前的研究结果应用于临床和研究时，必须考虑这些注意事项。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Veterinary Internal Medicine 农林科学-兽医学

CiteScore

4.50

自引率

11.50%

发文量

243

审稿时长

22 weeks

期刊介绍： The mission of the Journal of Veterinary Internal Medicine is to advance veterinary medical knowledge and improve the lives of animals by publication of authoritative scientific articles of animal diseases.