Evaluation of serum biomarkers C-reactive protein and albumin in diagnostics of primary immune-mediated polyarthritis in dogs.

Bayer, K; Jasensky, AK; Merle, R; Weber, C; Muller, E; Kohn, B

Abstract

Introduction: Canine primary (idiopathic) immune-mediated polyarthritis (IPA) is a non-infectious inflammatory joint disease, characterized by synovitis and commonly accompanied by systemic signs of disease. Acute phase proteins are used for diagnosis, prognosis and monitoring of therapeutic success in a wide variety of diseases but only limited data is available regarding their use in canine IPA. Aim: The aim of this prospective study was to measure the leukocyte count, C-reactive protein (CRP) and albumin in dogs with IPA, to compare them with clinical progression under therapy, and evaluate their significance in terms of monitoring. Material and methods: Included were dogs with IPA with a complete diagnostic work-up and a follow-up examination at least four times. At each follow-up examination, clinical and laboratory data were recorded and CRP, the leukocyte count and albumin concentration were measured on day 0 (T0), within day 2-7 (T1), day 8-14 (T2), week 3-4 (T3) and week 5-8 (T4) and in some cases beyond these time periods. Results: Twenty-one dogs with IPA were enrolled in the study and were treated immunosuppressively with prednisolone. Additionally, leflunomide (ten dogs), cyclosporine (three dogs) and mycophenolate mofetil (one dog) were given in several cases. All dogs were examined at T0, 20/21 at T1 and T2, respectively 19/21 at T3 and 16/21 at T4. CRP was elevated in all dogs at T0 (16-169 mg/l; median 97.1 mg/l; cut-off value 10 mg/l) and 13 dogs had hypoalbuminemia (mean 26.1 g/l; SD 3.4 g/l; reference range: 28-36 g/l). At time point T4, there was a significant (p < 0.0001) decrease in CRP concentration (0.5-38.5 mg/l; median 1.8 mg/l) and 19 dogs had a concentration below the cut-off value. Albumin concentrations increased significantly (p = 0.006) at time point T4 (mean 30.7 g/l, SD 1.8 g/l) and 14 dogs had a concentration in the reference range. The leukocyte counts were not significantly different between time point T0 and T4. Relapse occurred in eight dogs. CRP concentration increased significantly (19.9-159 mg/l [median 66.3 mg/l]) in patients with recurrence of disease and decreased following adjustment of therapy. The changes of the leukocyte count and albumin concentration were not significant at the time point of relapse compared to the last examination before relapse. Conclusion: CRP can be used as a biomarker for monitoring of IPA in dogs. The concentration of CRP during follow-up measurements reflects the course of disease best compared to leukocyte count albumin concentration. It quickly and accurately indicates response to therapy and a recurrence of disease.

Citation

Bayer, K., Jasensky, A., Merle, R., Weber, C., Muller, E., & Kohn, B. (2023). Evaluation of serum biomarkers C-reactive protein and albumin in diagnostics of primary immune-mediated polyarthritis in dogs. Kleintierpraxis, 68(3), 116-126. https://doi.org/10.2377/0023-2076-68-116

• Journal Article Type: Article
• Acceptance Date: Dec 16, 2022
• Online Publication Date: Mar 15, 2023
• Publication Date: 2023
• Deposit Date: Feb 8, 2024
• Publicly Available Date: Feb 8, 2024
• Print ISSN: 0023-2076
• Publisher: German Society for Small Animal Medicine (DGK-DVG)
• Peer Reviewed: Peer Reviewed
• Volume: 68
• Issue: 3
• Pages: 116-126
• DOI: https://doi.org/10.2377/0023-2076-68-116
• Keywords: acute phase protein; immune-mediated disease; arthritis; ACUTE-PHASE PROTEINS; JOINT DISEASE; EFFICACY; LEFLUNOMIDE