PMID- 32928489
OWN - NLM
STAT- MEDLINE
DCOM- 20210115
LR  - 20210115
IS  - 1532-2971 (Electronic)
IS  - 1090-0233 (Linking)
VI  - 263
DP  - 2020 Sep
TI  - Diagnostic contribution of individual components of adrenal function tests to 
      diagnose canine hyperadrenocorticism.
PG  - 105520
LID - S1090-0233(20)30097-6 [pii]
LID - 10.1016/j.tvjl.2020.105520 [doi]
AB  - There is limited information regarding the value of constitutive components of 
      the ACTH stimulation test (ACTHST) and low-dose dexamethasone suppression test 
      (LDDST) including serum baseline cortisol (BC), difference between post-ACTH 
      stimulation cortisol (PC) and BC (DeltaACTHC), cortisol concentration 4h after 
      dexamethasone administration (4HC), difference between 4HC and BC (Delta4C), and the 
      difference between cortisol concentration 8h after dexamethasone administration 
      and 4HC (Delta8C). Therefore, the objective of this study was to determine if these 
      components can predict hyperadrenocorticism, pituitary-dependent 
      hyperadrenocorticism (PDH), or functional adrenocortical tumor (FAT) in dogs. 
      Cortisol concentrations were normalized, as fold change (FC), to the PC reference 
      interval upper limit. A total of 1267 dogs were included, with 
      hyperadrenocorticism diagnosed in 537 (PDH, n=356; FAT, n=28; undetermined, 
      n=153) and excluded in 730. The area under the receiver operating curves for BC, 
      DeltaACTHC, 4HC, Delta4C, and Delta8C to predict hyperadrenocorticism were 0.76 (95% 
      confidence interval (CI), 0.73-0.79), 0.91 (95% CI, 0.89-0.93), 0.83 (95% CI, 
      0.80-0.87), 0.55 (95% CI, 0.50-0.60), and 0.67 (95% CI, 0.62-0.72), respectively. 
      A diagnostic limit of >/=0.78 FC for DeltaACTHC had excellent sensitivity (1.00; 95% 
      CI, 0.74-1.00), but poor specificity (0.67; 95% CI, 0.64-0.71), to predict FAT in 
      dogs with a positive ACTHST. A diagnostic limit of >/=-0.26 FC for Delta4C had 
      excellent sensitivity (1.00; 95% CI, 0.79-1.00), but poor specificity (0.21; 95% 
      CI, 0.18-0.26), to predict FAT in dogs with a positive LDDST. In 
      hyperadrenocorticoid dogs that have positive ACTHST or LDDST results, DeltaACTHC or 
      Delta4C, respectively, could be used to exclude FAT.
CI  - Copyright (c) 2020 Elsevier Ltd. All rights reserved.
FAU - Jaffey, J A
AU  - Jaffey JA
AD  - Department of Specialty Medicine, College of Veterinary Medicine, Midwestern 
      University, 19555 N. 59th Ave, Glendale, AZ, USA; Department of Veterinary 
      Medicine and Surgery, Veterinary Health Center, University of Missouri, 900 East 
      Campus Drive, Columbia, MO, USA. Electronic address: jjaffe@midwestern.edu.
FAU - Hess, R S
AU  - Hess RS
AD  - Department of Clinical Sciences & Advanced Medicine, School of Veterinary 
      Medicine, University of Pennsylvania, Philadelphia, PA, USA.
FAU - Webster, C R
AU  - Webster CR
AD  - Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts 
      University, 200 Westboro Road, North Grafton, MA, USA.
FAU - Blois, S L
AU  - Blois SL
AD  - Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 
      Guelph, ON N1G 2W1, Canada.
FAU - Hostnik, E T
AU  - Hostnik ET
AD  - Department of Veterinary Clinical Sciences, Veterinary Medical Center, Ohio State 
      University, 601 Vernon L Tharp Street Columbus, OH, USA.
FAU - Heilmann, R M
AU  - Heilmann RM
AD  - Small Animal Clinic, Veterinary Teaching Hospital, College of Veterinary 
      Medicine, University of Leipzig, An den Tierkliniken 23, DE-04103 Leipzig, 
      Saxony, Germany.
FAU - Jacobs, C
AU  - Jacobs C
AD  - Department of Medical Sciences, School of Veterinary Medicine, University of 
      Wisconsin-Madison, Madison, Wisconsin, USA.
FAU - Steiner, J M
AU  - Steiner JM
AD  - Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas 
      A&M University, College Station, Texas, USA.
FAU - Reusch, C E
AU  - Reusch CE
AD  - Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of 
      Zurich, Zurich, Switzerland.
FAU - Rogers, E
AU  - Rogers E
AD  - Department of Veterinary Medicine and Surgery, Veterinary Health Center, 
      University of Missouri, 900 East Campus Drive, Columbia, MO, USA.
FAU - Royal, A
AU  - Royal A
AD  - Department of Veterinary Pathobiology, Veterinary Health Center, University of 
      Missouri, 900 East Campus Drive, Columbia, MO, USA.
FAU - Piech, T
AU  - Piech T
AD  - Department of Specialty Medicine, College of Veterinary Medicine, Midwestern 
      University, 19555 N. 59th Ave, Glendale, AZ, USA.
FAU - Musella, C
AU  - Musella C
AD  - Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of 
      Zurich, Zurich, Switzerland.
FAU - Carvalho, L
AU  - Carvalho L
AD  - Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts 
      University, 200 Westboro Road, North Grafton, MA, USA.
FAU - Fink, M J
AU  - Fink MJ
AD  - Department of Clinical Sciences & Advanced Medicine, School of Veterinary 
      Medicine, University of Pennsylvania, Philadelphia, PA, USA.
FAU - Motta, G E
AU  - Motta GE
AD  - Department of Clinical Sciences & Advanced Medicine, School of Veterinary 
      Medicine, University of Pennsylvania, Philadelphia, PA, USA.
FAU - Kilkucki, S N
AU  - Kilkucki SN
AD  - Department of Clinical Sciences & Advanced Medicine, School of Veterinary 
      Medicine, University of Pennsylvania, Philadelphia, PA, USA.
FAU - Cigarro, A
AU  - Cigarro A
AD  - Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas 
      A&M University, College Station, Texas, USA.
FAU - Roedler, F S
AU  - Roedler FS
AD  - Small Animal Clinic, Veterinary Teaching Hospital, College of Veterinary 
      Medicine, University of Leipzig, An den Tierkliniken 23, DE-04103 Leipzig, 
      Saxony, Germany.
FAU - Seidel, T
AU  - Seidel T
AD  - Department of Veterinary Medicine and Surgery, Veterinary Health Center, 
      University of Missouri, 900 East Campus Drive, Columbia, MO, USA.
FAU - DeClue, A E
AU  - DeClue AE
AD  - Department of Veterinary Medicine and Surgery, Veterinary Health Center, 
      University of Missouri, 900 East Campus Drive, Columbia, MO, USA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20200802
PL  - England
TA  - Vet J
JT  - Veterinary journal (London, England : 1997)
JID - 9706281
RN  - 7S5I7G3JQL (Dexamethasone)
RN  - 9002-60-2 (Adrenocorticotropic Hormone)
RN  - WI4X0X7BPJ (Hydrocortisone)
SB  - IM
MH  - Adrenal Cortex Neoplasms/diagnosis/physiopathology/veterinary
MH  - Adrenal Glands/*physiopathology
MH  - Adrenocortical Hyperfunction/diagnosis/*veterinary
MH  - Adrenocorticotropic Hormone/administration & dosage
MH  - Animals
MH  - Area Under Curve
MH  - Dexamethasone/administration & dosage
MH  - Dog Diseases/*diagnosis/physiopathology
MH  - Dogs
MH  - Female
MH  - Hydrocortisone/blood
MH  - Male
MH  - Pituitary Gland/physiopathology
MH  - ROC Curve
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
OTO - NOTNLM
OT  - Cushing's syndrome
OT  - Functional adrenocortical tumor
OT  - Hypercortisolemia
OT  - Pituitary dependent hyperadrenocorticism
COIS- Declaration of Competing Interest The authors report no declarations of interest.
EDAT- 2020/09/16 06:00
MHDA- 2021/01/16 06:00
CRDT- 2020/09/15 05:38
PHST- 2020/02/02 00:00 [received]
PHST- 2020/07/12 00:00 [revised]
PHST- 2020/07/15 00:00 [accepted]
PHST- 2020/09/15 05:38 [entrez]
PHST- 2020/09/16 06:00 [pubmed]
PHST- 2021/01/16 06:00 [medline]
AID - S1090-0233(20)30097-6 [pii]
AID - 10.1016/j.tvjl.2020.105520 [doi]
PST - ppublish
SO  - Vet J. 2020 Sep;263:105520. doi: 10.1016/j.tvjl.2020.105520. Epub 2020 Aug 2.