A portion of this work was presented in abstract form at the 2010 ACVIM Forum in Anaheim CA
Serum and Urine Blastomyces Antigen Concentrations as Markers of Clinical Remission in Dogs Treated for Systemic Blastomycosis
Article first published online: 3 FEB 2014
Copyright © 2014 by the American College of Veterinary Internal Medicine
Journal of Veterinary Internal Medicine
Volume 28, Issue 2, pages 305–310, March/April 2014
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How to Cite
Foy, D.S., Trepanier, L.A., Kirsch, E.J. and 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: 305–310. doi: 10.1111/jvim.12306
- Issue published online: 15 MAR 2014
- Article first published online: 3 FEB 2014
- Manuscript Accepted: 17 DEC 2013
- Manuscript Revised: 8 NOV 2013
- Manuscript Received: 26 JUL 2013
- MiraVista Diagnostics
- Systemic fungal infection
Serum and urine Blastomyces antigen concentrations can be used to diagnose blastomycosis in dogs.
Blastomyces antigen concentrations correlate with clinical remission in dogs during antifungal treatment, and detect disease relapse after treatment discontinuation.
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).
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.
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.
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.