Diagnostic performance of an in-clinic cortisol assay in dogs with suspected hypoadrenocorticism.

IF 1.4 3区农林科学 Q2 VETERINARY SCIENCES

American journal of veterinary research Pub Date : 2025-07-30 DOI:10.2460/ajvr.25.04.0132

Ana Torrano Guillamón, Casandra Juárez Sarrión, Eva Prosper Asensi, Jorge Castro López, Paula García San José, Carolina Arenas Bermejo

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引用次数: 0

Abstract

Objective: To assess the diagnostic accuracy of the rapid point-of-care ELISA by IDEXX (SNAP) for detecting hypoadrenocorticism (HA) in dogs. A secondary aim was to evaluate the agreement between the SNAP and the veterinary reference laboratory (VRL) using chemiluminescent enzyme immunoassay (IMMULITE 2000) cortisol measurements. We hypothesized that the SNAP would correlate well with the VRL and aid in HA diagnosis.

Methods: A prospective observational diagnostic accuracy study was conducted from January 2023 through January 2024, enrolling dogs with suspected HA. Hypoadrenocorticism was diagnosed using an ACTH stimulation test, with basal serum cortisol (BSC) used for screening in some cases. Samples were analyzed by the SNAP and VRL, with the VRL serving as the gold standard.

Results: 96 dogs were enrolled; 21 were diagnosed with HA. The SNAP showed correlation with the VRL (Spearman ρ = 0.923; P < .001). Median BSC and post-ACTH cortisol concentrations did not differ significantly between methods. A BSC < 2 µg/dL yielded 100% sensitivity for both, with the SNAP showing higher specificity (73.1%) than the VRL (64.2%). Post-ACTH cortisol < 2 µg/dL was 100% specific by both methods, with 95.2% sensitivity using the SNAP. A 10.5% clinical discordance was observed. Passing-Bablok regression revealed proportional and constant bias, with the SNAP test tending to overestimate cortisol concentrations, but in the low cortisol range this overestimation appears minimal.

Conclusions: The SNAP correlated with the VRL for HA diagnosis; however, borderline post-ACTH SNAP results should be confirmed with the VRL. The SNAP-derived BSC may be more specific than the VRL for ruling out HA.

Clinical relevance: The SNAP test aids HA diagnosis in urgent care.

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临床诊断性能的皮质醇测定在狗与怀疑肾上腺皮质功能低下。

目的：评价IDEXX （SNAP）快速点护理ELISA检测犬肾上腺皮质激素减退症（HA）的诊断准确性。第二个目的是使用化学发光酶免疫测定法（IMMULITE 2000）测量皮质醇，评估SNAP和兽医参考实验室（VRL）之间的一致性。我们假设SNAP与VRL有很好的相关性，有助于HA的诊断。方法：从2023年1月到2024年1月进行了一项前瞻性观察性诊断准确性研究，纳入了疑似HA的狗。肾上腺皮质功能减退症的诊断使用ACTH刺激试验，与基础血清皮质醇（BSC）用于筛选在某些情况下。样品采用SNAP和VRL进行分析，以VRL为金标准。结果：96只狗入选；21人被诊断为HA。SNAP与VRL相关(Spearman ρ = 0.923；P < 0.001)。两种方法间BSC和acth后皮质醇浓度中值无显著差异。BSC < 2µg/dL对两者的敏感性均为100%，SNAP的特异性（73.1%）高于VRL（64.2%）。两种方法对acth后皮质醇< 2µg/dL的特异性均为100%，SNAP的敏感性为95.2%。临床差异为10.5%。pass - bablok回归显示成比例和恒定偏差，SNAP测试倾向于高估皮质醇浓度，但在低皮质醇范围内，这种高估似乎很小。结论：SNAP与VRL在HA诊断中的相关性；然而，acth后边缘性SNAP结果应与VRL确认。snap衍生的BSC在排除HA方面可能比VRL更具体。临床相关性：SNAP测试有助于在紧急护理中诊断HA。

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来源期刊

American journal of veterinary research 农林科学-兽医学

CiteScore

1.70

自引率

10.00%

发文量

186

审稿时长

3 months

期刊介绍： The American Journal of Veterinary Research supports the collaborative exchange of information between researchers and clinicians by publishing novel research findings that bridge the gulf between basic research and clinical practice or that help to translate laboratory research and preclinical studies to the development of clinical trials and clinical practice. The journal welcomes submission of high-quality original studies and review articles in a wide range of scientific fields, including anatomy, anesthesiology, animal welfare, behavior, epidemiology, genetics, heredity, infectious disease, molecular biology, oncology, pharmacology, pathogenic mechanisms, physiology, surgery, theriogenology, toxicology, and vaccinology. Species of interest include production animals, companion animals, equids, exotic animals, birds, reptiles, and wild and marine animals. Reports of laboratory animal studies and studies involving the use of animals as experimental models of human diseases are considered only when the study results are of demonstrable benefit to the species used in the research or to another species of veterinary interest. Other fields of interest or animals species are not necessarily excluded from consideration, but such reports must focus on novel research findings. Submitted papers must make an original and substantial contribution to the veterinary medicine knowledge base; preliminary studies are not appropriate.