Accuracy of an Adrenocorticotropic Hormone (ACTH) Immunoluminometric Assay for Differentiating ACTH-Dependent from ACTH-Independent Hyperadrenocorticism in Dogs
Background: Adrenocorticotropic hormone (ACTH) determination has been used for 30 years to distinguish ACTH‐dependent hyperadrenocorticism (ADHAC) from ACTH‐independent hyperadrenocorticism (AIHAC) in dogs. However, the few studies that have evaluated its diagnostic accuracy, based in the majority o...
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| Veröffentlicht in: | Journal of veterinary internal medicine 2009-07, Vol.23 (4), p.850-855 |
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| creator | Rodríguez Piñeiro, M.I Benchekroun, G Fornel-Thibaud, P. de Maurey-Guenec, C Garnier, F Rosenberg, D |
| description | Background: Adrenocorticotropic hormone (ACTH) determination has been used for 30 years to distinguish ACTH‐dependent hyperadrenocorticism (ADHAC) from ACTH‐independent hyperadrenocorticism (AIHAC) in dogs. However, the few studies that have evaluated its diagnostic accuracy, based in the majority of cases on older assays, have been associated with systematic, but highly variable proportions of misclassified or unclassified cases.
Objective: The purpose of the present study is to evaluate the accuracy of a validated ACTH immunoluminometric assay (ILMA) for differentiating between ADHAC and AIHAC.
Animals: One hundred and nine dogs with hyperadrenocorticism were included: 91 with ADHAC and 18 with AIHAC.
Methods: Retrospective study. Dogs displaying feedback inhibition after the dexamethasone suppression test, adrenal symmetry, or both were considered to have ADHAC. AIHAC was demonstrated by adrenal tumor histology. For each group, ACTH determination by ILMA was reviewed.
Results: In the ADHAC group, plasma ACTH measurements ranged between 6 and 1250 pg/mL (median, 30 pg/mL). In the AIHAC group, all ACTH concentrations were below the lower quantification limit of the assay ( |
| doi_str_mv | 10.1111/j.1939-1676.2009.0328.x |
| format | Article |
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Objective: The purpose of the present study is to evaluate the accuracy of a validated ACTH immunoluminometric assay (ILMA) for differentiating between ADHAC and AIHAC.
Animals: One hundred and nine dogs with hyperadrenocorticism were included: 91 with ADHAC and 18 with AIHAC.
Methods: Retrospective study. Dogs displaying feedback inhibition after the dexamethasone suppression test, adrenal symmetry, or both were considered to have ADHAC. AIHAC was demonstrated by adrenal tumor histology. For each group, ACTH determination by ILMA was reviewed.
Results: In the ADHAC group, plasma ACTH measurements ranged between 6 and 1250 pg/mL (median, 30 pg/mL). In the AIHAC group, all ACTH concentrations were below the lower quantification limit of the assay (<5 pg/mL). The 95% confidence interval was 85–100% for sensitivity and 97–100% for specificity in AIHAC diagnosis.
Conclusion and Clinical Importance: No overlap in ACTH concentrations was observed between dogs with ADHAC and dogs with AIHAC. The use of a new technique with high analytical sensitivity made it possible to use a low threshold (5 pg/mL), avoiding the misclassification of some ADHAC cases with low, but quantifiable concentrations of ACTH. The assessment of ACTH concentrations by ILMA is an accurate tool for differentiating between ADHAC and AIHAC.</description><identifier>ISSN: 0891-6640</identifier><identifier>EISSN: 1939-1676</identifier><identifier>DOI: 10.1111/j.1939-1676.2009.0328.x</identifier><identifier>PMID: 19496909</identifier><language>eng</language><publisher>Malden, USA: Blackwell Publishing Inc</publisher><subject>Adrenal gland ; Adrenocortical tumors ; Adrenocorticotropic hormone ; Adrenocorticotropic Hormone - blood ; Animals ; corticotropin ; diagnostic techniques ; Dog Diseases - blood ; Dog Diseases - diagnosis ; Dogs ; Endocrinology ; hyperadrenocorticism ; Hyperaldosteronism - diagnosis ; Hyperaldosteronism - veterinary ; immunoassays ; Luminescent Measurements - veterinary ; Reproducibility of Results ; Retrospective Studies</subject><ispartof>Journal of veterinary internal medicine, 2009-07, Vol.23 (4), p.850-855</ispartof><rights>Copyright © 2009 by the American College of Veterinary Internal Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4758-4b3dbcb5f59f5b00618d1fd0a2e5dcd87fa99b12630435de2344efd25773fe703</citedby><cites>FETCH-LOGICAL-c4758-4b3dbcb5f59f5b00618d1fd0a2e5dcd87fa99b12630435de2344efd25773fe703</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1939-1676.2009.0328.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1939-1676.2009.0328.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,11560,27922,27923,45572,45573,46050,46474</link.rule.ids><linktorsrc>$$Uhttps://onlinelibrary.wiley.com/doi/abs/10.1111%2Fj.1939-1676.2009.0328.x$$EView_record_in_Wiley-Blackwell$$FView_record_in_$$GWiley-Blackwell</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19496909$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rodríguez Piñeiro, M.I</creatorcontrib><creatorcontrib>Benchekroun, G</creatorcontrib><creatorcontrib>Fornel-Thibaud, P. de</creatorcontrib><creatorcontrib>Maurey-Guenec, C</creatorcontrib><creatorcontrib>Garnier, F</creatorcontrib><creatorcontrib>Rosenberg, D</creatorcontrib><title>Accuracy of an Adrenocorticotropic Hormone (ACTH) Immunoluminometric Assay for Differentiating ACTH-Dependent from ACTH-Independent Hyperadrenocorticism in Dogs</title><title>Journal of veterinary internal medicine</title><addtitle>J Vet Intern Med</addtitle><description>Background: Adrenocorticotropic hormone (ACTH) determination has been used for 30 years to distinguish ACTH‐dependent hyperadrenocorticism (ADHAC) from ACTH‐independent hyperadrenocorticism (AIHAC) in dogs. However, the few studies that have evaluated its diagnostic accuracy, based in the majority of cases on older assays, have been associated with systematic, but highly variable proportions of misclassified or unclassified cases.
Objective: The purpose of the present study is to evaluate the accuracy of a validated ACTH immunoluminometric assay (ILMA) for differentiating between ADHAC and AIHAC.
Animals: One hundred and nine dogs with hyperadrenocorticism were included: 91 with ADHAC and 18 with AIHAC.
Methods: Retrospective study. Dogs displaying feedback inhibition after the dexamethasone suppression test, adrenal symmetry, or both were considered to have ADHAC. AIHAC was demonstrated by adrenal tumor histology. For each group, ACTH determination by ILMA was reviewed.
Results: In the ADHAC group, plasma ACTH measurements ranged between 6 and 1250 pg/mL (median, 30 pg/mL). In the AIHAC group, all ACTH concentrations were below the lower quantification limit of the assay (<5 pg/mL). The 95% confidence interval was 85–100% for sensitivity and 97–100% for specificity in AIHAC diagnosis.
Conclusion and Clinical Importance: No overlap in ACTH concentrations was observed between dogs with ADHAC and dogs with AIHAC. The use of a new technique with high analytical sensitivity made it possible to use a low threshold (5 pg/mL), avoiding the misclassification of some ADHAC cases with low, but quantifiable concentrations of ACTH. The assessment of ACTH concentrations by ILMA is an accurate tool for differentiating between ADHAC and AIHAC.</description><subject>Adrenal gland</subject><subject>Adrenocortical tumors</subject><subject>Adrenocorticotropic hormone</subject><subject>Adrenocorticotropic Hormone - blood</subject><subject>Animals</subject><subject>corticotropin</subject><subject>diagnostic techniques</subject><subject>Dog Diseases - blood</subject><subject>Dog Diseases - diagnosis</subject><subject>Dogs</subject><subject>Endocrinology</subject><subject>hyperadrenocorticism</subject><subject>Hyperaldosteronism - diagnosis</subject><subject>Hyperaldosteronism - veterinary</subject><subject>immunoassays</subject><subject>Luminescent Measurements - veterinary</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><issn>0891-6640</issn><issn>1939-1676</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc2O0zAURiMEYsrAKzBeIVik2PFfLbGJWmiLCiyYAakby3HsyqWJO3Yi2rfhUXGUMrDEG1ufznevpZNlNwhOUTpv91MksMgR42xaQCimEBez6elRNnnIH2cTOBMoZ4zAq-xZjHsIC0opf5pdIUEEE1BMsl-l1n1Q-gy8BaoFZR1M67UPndO-C_7oNFj50PjWgNfl_Hb1Bqybpm_9oW9c6xvThUSUMaozsD6AhbPWpBGdU51rd2Co5AtzNG2dQmCDb8ZsnYI_6ep8NEH9s9nFBrgWLPwuPs-eWHWI5sXlvs7uPry_na_yzZflel5uck04neWkwnWlK2qpsLSCkKFZjWwNVWForesZt0qIChUMQ4JpbQpMiLF1QTnH1nCIr7NX49xj8Pe9iZ1sXNTmcFCt8X2UjBOCCEMJ5COog48xGCuPwTUqnCWCcpAj93KQIAcJcpAjBznylJovLyv6qjH1397FRgLejcBPdzDn_50rP35bf0qvVM_HuoudOT3UVfiRfo85ld8_L-Vqy-fb-XYjl4m_GXmrvFS74KK8-1pAhCFijMGC4N_0zLjY</recordid><startdate>200907</startdate><enddate>200907</enddate><creator>Rodríguez Piñeiro, M.I</creator><creator>Benchekroun, G</creator><creator>Fornel-Thibaud, P. de</creator><creator>Maurey-Guenec, C</creator><creator>Garnier, F</creator><creator>Rosenberg, D</creator><general>Blackwell Publishing Inc</general><scope>FBQ</scope><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200907</creationdate><title>Accuracy of an Adrenocorticotropic Hormone (ACTH) Immunoluminometric Assay for Differentiating ACTH-Dependent from ACTH-Independent Hyperadrenocorticism in Dogs</title><author>Rodríguez Piñeiro, M.I ; Benchekroun, G ; Fornel-Thibaud, P. de ; Maurey-Guenec, C ; Garnier, F ; Rosenberg, D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4758-4b3dbcb5f59f5b00618d1fd0a2e5dcd87fa99b12630435de2344efd25773fe703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adrenal gland</topic><topic>Adrenocortical tumors</topic><topic>Adrenocorticotropic hormone</topic><topic>Adrenocorticotropic Hormone - blood</topic><topic>Animals</topic><topic>corticotropin</topic><topic>diagnostic techniques</topic><topic>Dog Diseases - blood</topic><topic>Dog Diseases - diagnosis</topic><topic>Dogs</topic><topic>Endocrinology</topic><topic>hyperadrenocorticism</topic><topic>Hyperaldosteronism - diagnosis</topic><topic>Hyperaldosteronism - veterinary</topic><topic>immunoassays</topic><topic>Luminescent Measurements - veterinary</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rodríguez Piñeiro, M.I</creatorcontrib><creatorcontrib>Benchekroun, G</creatorcontrib><creatorcontrib>Fornel-Thibaud, P. de</creatorcontrib><creatorcontrib>Maurey-Guenec, C</creatorcontrib><creatorcontrib>Garnier, F</creatorcontrib><creatorcontrib>Rosenberg, D</creatorcontrib><collection>AGRIS</collection><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of veterinary internal medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Rodríguez Piñeiro, M.I</au><au>Benchekroun, G</au><au>Fornel-Thibaud, P. de</au><au>Maurey-Guenec, C</au><au>Garnier, F</au><au>Rosenberg, D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Accuracy of an Adrenocorticotropic Hormone (ACTH) Immunoluminometric Assay for Differentiating ACTH-Dependent from ACTH-Independent Hyperadrenocorticism in Dogs</atitle><jtitle>Journal of veterinary internal medicine</jtitle><addtitle>J Vet Intern Med</addtitle><date>2009-07</date><risdate>2009</risdate><volume>23</volume><issue>4</issue><spage>850</spage><epage>855</epage><pages>850-855</pages><issn>0891-6640</issn><eissn>1939-1676</eissn><abstract>Background: Adrenocorticotropic hormone (ACTH) determination has been used for 30 years to distinguish ACTH‐dependent hyperadrenocorticism (ADHAC) from ACTH‐independent hyperadrenocorticism (AIHAC) in dogs. However, the few studies that have evaluated its diagnostic accuracy, based in the majority of cases on older assays, have been associated with systematic, but highly variable proportions of misclassified or unclassified cases.
Objective: The purpose of the present study is to evaluate the accuracy of a validated ACTH immunoluminometric assay (ILMA) for differentiating between ADHAC and AIHAC.
Animals: One hundred and nine dogs with hyperadrenocorticism were included: 91 with ADHAC and 18 with AIHAC.
Methods: Retrospective study. Dogs displaying feedback inhibition after the dexamethasone suppression test, adrenal symmetry, or both were considered to have ADHAC. AIHAC was demonstrated by adrenal tumor histology. For each group, ACTH determination by ILMA was reviewed.
Results: In the ADHAC group, plasma ACTH measurements ranged between 6 and 1250 pg/mL (median, 30 pg/mL). In the AIHAC group, all ACTH concentrations were below the lower quantification limit of the assay (<5 pg/mL). The 95% confidence interval was 85–100% for sensitivity and 97–100% for specificity in AIHAC diagnosis.
Conclusion and Clinical Importance: No overlap in ACTH concentrations was observed between dogs with ADHAC and dogs with AIHAC. The use of a new technique with high analytical sensitivity made it possible to use a low threshold (5 pg/mL), avoiding the misclassification of some ADHAC cases with low, but quantifiable concentrations of ACTH. The assessment of ACTH concentrations by ILMA is an accurate tool for differentiating between ADHAC and AIHAC.</abstract><cop>Malden, USA</cop><pub>Blackwell Publishing Inc</pub><pmid>19496909</pmid><doi>10.1111/j.1939-1676.2009.0328.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0891-6640 |
| ispartof | Journal of veterinary internal medicine, 2009-07, Vol.23 (4), p.850-855 |
| issn | 0891-6640 1939-1676 |
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| source | Wiley Online Library Open Access |
| subjects | Adrenal gland Adrenocortical tumors Adrenocorticotropic hormone Adrenocorticotropic Hormone - blood Animals corticotropin diagnostic techniques Dog Diseases - blood Dog Diseases - diagnosis Dogs Endocrinology hyperadrenocorticism Hyperaldosteronism - diagnosis Hyperaldosteronism - veterinary immunoassays Luminescent Measurements - veterinary Reproducibility of Results Retrospective Studies |
| title | Accuracy of an Adrenocorticotropic Hormone (ACTH) Immunoluminometric Assay for Differentiating ACTH-Dependent from ACTH-Independent Hyperadrenocorticism in Dogs |
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