title: Sensitivity and specificity of western blot testing of cerebrospinal fluid and serum for diagnosis of equine protozoal myeloencephalitis in horses with and without neurologic abnormalities.
abstract: OBJECTIVE
  To determine sensitivity and specificity of western blot testing (WBT) of CSF and serum for diagnosis of equine protozoal myeloencephalitis (EPM) in horses with and without neurologic abnormalities.
  
  
  METHODS
  Prospective investigation.
  
  
  METHODS
  65 horses with and 169 horses without neurologic abnormalities.
  
  
  METHODS
  CSF and serum from horses submitted for necropsy were tested for Sarcocystis neurona-specific antibody with a WBT. Results of postmortem examination were used as the gold standard against which results of the WBT were compared.
  
  
  RESULTS
  Sensitivity of WBT of CSF was 87% for horses with and 88% for horses without neurologic abnormalities. Specificity of WBT of CSF was 44% for horses with and 60% for horses without neurologic abnormalities. Regardless of whether horses did or did not have neurologic abnormalities, sensitivity and specificity of WBT of serum were not significantly different from values for WBT of CSF. Ninety-four horses without EPM had histologic evidence of slight CNS inflammation.
  
  
  CONCLUSIONS
  The low specificity of WBT of CSF indicated that it is inappropriate to diagnose EPM on the basis of a positive test result alone because of the possibility of false-positive test results. The high sensitivity, however, means that a negative result is useful in ruling out EPM. There was no advantage in testing CSF versus serum in horses without neurologic abnormalities. Slight CNS inflammation was common in horses with and without S neurona-specific antibodies in the CSF and should not be considered an indication of CNS infection with S neurona.
mesh_terms: D000818:Animals; D015153:Blotting, Western / Q000379:methods / Q000662:veterinary*; D004679:Encephalomyelitis / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000662:veterinary*; D005189:False Positive Reactions; D005260:Female; D006734:Horse Diseases / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D006736:Horses; D008297:Male; D011446:Prospective Studies; D012522:Sarcocystis / Q000276:immunology*; D012523:Sarcocystosis / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000662:veterinary*; D012680:Sensitivity and Specificity