Stiftung Tierärztliche Hochschule Hannover (TiHo)TiHo eLib

The Reibergram in neurological diseases of dogs

In various neurological diseases the total protein content in cerebrospinal
fluid (CSF) might be increased. To distinguish blood-CSF barrier
dysfunction (BD) and intrathecal immunoglobulin (Ig) synthesis (ITS)
albumin, mainly produced extracranially, can be used as a reference
marker for BD. But hitherto used linear regression models are insufficient
in detecting ITS or BD. In the present study a hyperbolic quotient
graph (=“Reibergram”) was developed based on albumin
CSF/serum quotients (QAlb) and IgA CSF/serum quotients (QIgA)
from 6 healthy Beagles and 38 client-owned dogs with diseases in
which an isolated BD was suspected. Quantile regression resulted in
the hyperbolic curve, QLim (IgA)= 0.13 √((QAlb) 2+11.9.10-6) –
1.01.10-3, where QLim (IgA) describes the upper limit of physiological
value of QIgA. The upper physiological value of QAlb was calculated
with a 95% confidence interval and is 2.22. Both lines QAlb and QLim
(IgA) were transferred into a graph, where they divide the diagram
into four sections: normal, isolated BD, isolated ITS of IgA and combined
BD & ITS of IgA. The canine Reibergram was validated with
118 dogs suffering from various neurological diseases and detects diseases
with suspected BD with a sensitivity and specificity of 81% and
89% respectively, and diseases with suspected ITS of IgA with a sensitivity
of 85% and specificity of 88%. The canine IgA Reibergram
allows the clinician to draw conclusions about the function of the
blood-CSF barrier and ITS of IgA and might aid as an additional tool in
the diagnostics of neurological diseases in dogs.

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