Pinn Toby L, Bender Hannah S, Stokol Tracy, Erb Hollis N, Schlafer Donald H, Perkins Gillian A
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
J Vet Diagn Invest. 2013 Jan;25(1):54-60. doi: 10.1177/1040638712471058.
Aberrant migration of Parelaphostrongylus tenuis in camelids results in neurologic deficits, recumbency, and sometimes death. An antemortem diagnosis of P. tenuis in camelids is typically based upon the presence of characteristic asymmetric neurologic deficits, known exposure to white-tailed deer, cerebrospinal fluid (CSF) eosinophilia, and response to treatment. The diagnostic accuracy of CSF eosinophil percentage for the diagnosis of P. tenuis in camelids has not been critically examined. The objective of the current study was to determine the sensitivity (Se) and specificity (Sp) of CSF eosinophil percentage, CSF eosinophil concentration, total nucleated cell concentration, and protein concentration for the antemortem diagnosis of P. tenuis. Medical records of camelids admitted to Cornell University with clinical signs of neurologic disease, CSF analysis, and necropsy were examined from January 2000 through December 2009. Se and Sp were determined by receiver operating characteristic curves in camelids diagnosed with P. tenuis (n = 13) or other conditions (n = 24) based on postmortem examination. More than 17% of eosinophils in CSF had a Se of 85% and Sp of 92% for P. tenuis diagnosis (area under the curve [AUC]: 0.87; SE AUC: 0.07; P < 0.0001; 95% confidence interval [CI] AUC: 0.72-0.96), and >1.4 eosinophils/µl of CSF had a Se of 85% and Sp of 96% (AUC: 0.9; SE AUC: 0.06; P < 0.0001; 95% CI AUC: 0.76-0.97). Cerebrospinal fluid eosinophil percentage and concentration are sensitive and specific methods for diagnosing P. tenuis antemortem in camelids residing in regions endemic to white-tailed deer.
细颈囊尾蚴在骆驼科动物体内异常移行可导致神经功能缺损、卧地不起，有时甚至死亡。骆驼科动物细颈囊尾蚴病的生前诊断通常基于特征性不对称神经功能缺损的存在、已知接触白尾鹿的情况、脑脊液（CSF）嗜酸性粒细胞增多以及对治疗的反应。尚未对脑脊液嗜酸性粒细胞百分比在骆驼科动物细颈囊尾蚴病诊断中的诊断准确性进行严格检验。本研究的目的是确定脑脊液嗜酸性粒细胞百分比、脑脊液嗜酸性粒细胞浓度、总核细胞浓度和蛋白质浓度在细颈囊尾蚴病生前诊断中的敏感性（Se）和特异性（Sp）。对2000年1月至2009年12月间因神经疾病临床症状、脑脊液分析和尸检而入住康奈尔大学的骆驼科动物的病历进行了检查。根据死后检查结果，通过受试者工作特征曲线确定了诊断为细颈囊尾蚴病（n = 13）或其他疾病（n = 24）的骆驼科动物的Se和Sp。脑脊液中嗜酸性粒细胞超过17%对细颈囊尾蚴病诊断的Se为85%，Sp为92%（曲线下面积[AUC]：0.87；SE AUC：0.07；P < 0.0001；95%置信区间[CI] AUC：0.72 - 0.96），脑脊液中嗜酸性粒细胞>1.4/µl的Se为85%，Sp为96%（AUC：0.9；SE AUC：0.06；P < 0.0001；95% CI AUC：0.76 - 0.97）。脑脊液嗜酸性粒细胞百分比和浓度是诊断生活在白尾鹿流行地区的骆驼科动物细颈囊尾蚴病生前诊断的敏感且特异的方法。
