Department of Medical Sciences, University of Wisconsin-Madison, School of Veterinary Medicine, 2015 Linden Dr, Madison, WI, 53706, USA.
Department of Specialty Medicine, Midwestern University, College of Veterinary Medicine, 19555 N 59th Ave, Glendale, AZ, 85308, USA.
Vet J. 2021 Aug;274:105707. doi: 10.1016/j.tvjl.2021.105707. Epub 2021 Jun 10.
Blastomycosis is a prominent fungal disease in the United States. Vitamin D status has been found to be altered in critical illness and various infectious diseases. The objectives of this study were to compare serum 25-hydroxyvitamin D (25[OH]D) concentrations in dogs with blastomycosis and healthy controls, to assess the change in serum 25(OH)D concentrations in dogs with blastomycosis after 30 days of treatment, and to determine if baseline serum 25(OH)D concentrations in dogs with blastomycosis were associated with in-hospital, 30-day, or end-of-study mortality. In this prospective cohort study, 19 dogs newly diagnosed with blastomycosis had serum 25(OH)D concentrations measured with a commercially available validated radioimmunoassay at the time of diagnosis and 30 days after start of treatment. These values were compared to 24 healthy control dogs. Serum 25(OH)D concentrations at the time of diagnosis were lower in dogs with blastomycosis (median, 203 nmol/L; range, 31-590 nmol/L) than in clinically healthy control dogs (259.5 nmol/L, 97-829 nmol/L; P = 0.01). Despite clinical improvement, there was no significant change in serum 25(OH)D concentrations from baseline to 30-day follow-up. Dogs with baseline serum 25(OH)D concentrations <180.5nmol/L had a greater odds of death during hospitalization (odds ratio [OR], 15.0; 95% confidence interval [CI], 1.4-191.3; P = 0.04) and at 30 days follow-up (OR, 30.0; 95% CI, 2.5-366.7; P = 0.006). These findings highlight the need for further studies evaluating the prognostic value of vitamin D status in dogs with blastomycosis at diagnosis and throughout treatment and remission.
芽生菌病是美国一种重要的真菌病。人们已经发现，在危重病和各种传染病中，维生素 D 状态会发生改变。本研究的目的是比较患有芽生菌病和健康对照犬的血清 25-羟维生素 D（25[OH]D）浓度，评估治疗 30 天后患有芽生菌病犬的血清 25（OH）D 浓度变化，并确定患有芽生菌病犬的基线血清 25（OH）D 浓度是否与住院期间、30 天或研究结束时的死亡率相关。在这项前瞻性队列研究中，19 只新诊断患有芽生菌病的犬在诊断时和治疗开始后 30 天使用商业上可用的经验证的放射免疫测定法测量血清 25（OH）D 浓度，这些值与 24 只健康对照犬进行了比较。患有芽生菌病犬的血清 25（OH）D 浓度在诊断时较低（中位数，203 nmol/L；范围，31-590 nmol/L），低于临床健康对照犬（259.5 nmol/L，97-829 nmol/L；P = 0.01）。尽管临床状况有所改善，但从基线到 30 天随访时，血清 25（OH）D 浓度没有显著变化。基线血清 25（OH）D 浓度 <180.5nmol/L 的犬在住院期间（比值比 [OR]，15.0；95%置信区间 [CI]，1.4-191.3；P = 0.04）和 30 天随访时（OR，30.0；95% CI，2.5-366.7；P = 0.006）死亡的可能性更大。这些发现强调了需要进一步研究评估在诊断和整个治疗及缓解期间，维生素 D 状态对患有芽生菌病犬的预后价值。
