Agreement in histologic assessments of the pituitary pars intermedia in aged horses.
Abstract: To evaluate concordance among veterinary pathologists in the assessment of histologic findings in the pars intermedia of pituitary gland sections from aged horses with mild signs suggestive of pituitary pars intermedia dysfunction (PPID). Sample Population-10 pituitary glands from aged horses. Methods: 7 pathologists were provided with signalment, clinical signs, and a single H&E-stained pituitary gland section from 10 aged horses with mild signs suggestive of PPID. Pathologists described histologic findings for each section and stated whether findings were consistent with PPID. Agreement among pathologists and with antemortem diagnostic test results was calculated. Results: Overall, only fair agreement was found among the pathologists as to which horses had histologic findings consistent with disease (mean +/- SE kappa value, 0.34 +/- 0.069). Interpretation of individual sections varied, with minimal agreement (4 or 5/7 pathologists) for 5 of 10 sections evaluated. Postmortem assessment was in agreement with an antemortem endocrine diagnostic test result 79% of the time. Conclusions: Validation of antemortem diagnostic testing for PPID in horses often relies on the results of postmortem histologic evaluation. The lack of consensus in histologic interpretation of pituitary glands from aged horses with mild clinical signs in our study indicates that postmortem histologic evaluation of pituitary glands is an inappropriate standard in validation of antemortem diagnostic tests for detection of early PPID. Caution should be used when interpreting diagnostic test results in horses in which early PPID is suspected.
Publication Date: 2005-12-29 PubMed ID: 16379646DOI: 10.2460/ajvr.2005.66.2055Google Scholar: Lookup
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- Comparative Study
- Journal Article
Summary
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The research study looked at the agreement among veterinary pathologists in interpreting histologic assessments of the pituitary pars intermedia in older horses displaying mild symptoms of pituitary pars intermedia dysfunction (PPID). The study revealed a lack of consensus among the pathologists, questioning the validity of postmortem evaluations as a standard for diagnosing early PPID.
Research Methodology
- The sample for this study consisted of 10 pituitary glands taken from elderly horses exhibiting minor symptoms of pituitary pars intermedia dysfunction (PPID).
- Seven veterinary pathologists were given the task of examining the samples which included the patients’ medical history, clinical signs, and one H&E-stained pituitary gland section from each of the 10 horses.
- The pathologists had to describe the histologic findings for each section and state whether these findings were in accordance with PPID. The level of agreement among pathologists and the consistency with antemortem diagnostic test results were then calculated.
Research Findings
- The overall findings of the study indicated a fair agreement among the pathologists regarding the presence of histologic findings that align with the disease (mean kappa value of about 0.34).
- However, interpretation of individual sections showed substantial inconsistencies, with minimal agreement for 5 out of the 10 sections evaluated.
- Postmortem assessments agreed with an antemortem endocrine diagnostic test result about 79% of the time.
Conclusion on Limitation of Use of Postmortem Histologic Evaluation
- The validation of antemortem diagnostic testing for PPID in horses often relies on the results of postmortem histologic evaluation of pituitary glands. However, the lack of consensus in this study indicates that the usage of postmortem histologic evaluation is not a reliable standard for validation in detecting early PPID in horses.
- The study emphasizes the need for caution when interpreting diagnostic test results in horses in which early PPID is suspected, as there may be limitations and discrepancies in the current methodology.
Cite This Article
APA
McFarlane D, Miller LM, Craig LE, Dybdal NO, Habecker PL, Miller MA, Patterson JS, Cribb AE.
(2005).
Agreement in histologic assessments of the pituitary pars intermedia in aged horses.
Am J Vet Res, 66(12), 2055-2059.
https://doi.org/10.2460/ajvr.2005.66.2055 Publication
Researcher Affiliations
- Department of Biomedical Sciences, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada.
MeSH Terms
- Age Factors
- Animals
- Dexamethasone / metabolism
- Histological Techniques / veterinary
- Horse Diseases / diagnosis
- Horse Diseases / pathology
- Horses
- Pituitary Diseases / diagnosis
- Pituitary Diseases / pathology
- Pituitary Diseases / veterinary
- Pituitary Gland / pathology
- alpha-MSH / blood
Citations
This article has been cited 6 times.- Kirkwood NC, Hughes KJ, Stewart AJ. Prospective Case Series of Clinical Signs and Adrenocorticotrophin (ACTH) Concentrations in Seven Horses Transitioning to Pituitary Pars Intermedia Dysfunction (PPID).. Vet Sci 2022 Oct 17;9(10).
- Kirkwood NC, Hughes KJ, Stewart AJ. Pituitary Pars Intermedia Dysfunction (PPID) in Horses.. Vet Sci 2022 Oct 10;9(10).
- Hinrichsen SL, Yuen KY, Dryburgh EL, Bertin FR, Stewart AJ. Short-Term Effects of Temperature and Thyrotropin-Releasing Hormone Stimulation on Adrenocorticotropin Stability in Horses.. Animals (Basel) 2022 Jan 28;12(3).
- Tatum RC, McGowan CM, Dean RS, Ireland JL. Equine pituitary pars intermedia dysfunction: Identifying research priorities for diagnosis, treatment and prognosis through a priority setting partnership.. PLoS One 2021;16(1):e0244784.
- Horn R, Stewart AJ, Jackson KV, Dryburgh EL, Medina-Torres CE, Bertin FR. Clinical implications of using adrenocorticotropic hormone diagnostic cutoffs or reference intervals to diagnose pituitary pars intermedia dysfunction in mature horses.. J Vet Intern Med 2021 Jan;35(1):560-570.
- Spelta CW. Equine pituitary pars intermedia dysfunction: current perspectives on diagnosis and management.. Vet Med (Auckl) 2015;6:293-300.
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