{"id":55286,"date":"2026-06-09T15:10:06","date_gmt":"2026-06-09T13:10:06","guid":{"rendered":"https:\/\/www.mylav.net\/?p=55286"},"modified":"2026-06-09T15:10:06","modified_gmt":"2026-06-09T13:10:06","slug":"rccu-diagnostic-maladie-addison-chien","status":"publish","type":"post","link":"https:\/\/www.mylav.net\/fr\/endocrinologie\/rccu-diagnostic-maladie-addison-chien\/","title":{"rendered":"Le rapport cortisol\/cr\u00e9atinine urinaires dans le diagnostic de la maladie d’Addison chez le chien : un outil plus performant qu’attendu"},"content":{"rendered":"

La mesure du rapport cortisol\/cr\u00e9atinine urinaires (RCCU) a longtemps \u00e9t\u00e9 n\u00e9glig\u00e9e comme outil diagnostique de l’hypoadr\u00e9nocorticisme canin. Une \u00e9tude, publi\u00e9e par des internistes italiens en collaboration avec MYLAV, en r\u00e9v\u00e8le les performances diagnostiques.<\/p>\n

Le test de r\u00e9f\u00e9rence pour confirmer une suspicion clinique de maladie d’Addison chez le chien reste le test de stimulation \u00e0 l’ACTH : chez les chiens addisoniens, le cortisol pr\u00e9- et post-stimulation est souvent indosable et pratiquement toujours inf\u00e9rieur \u00e0 2 \u00b5g\/dL.<\/p>\n

Ces derni\u00e8res ann\u00e9es, pour des raisons pratiques (\u00e9viter un double pr\u00e9l\u00e8vement et les contraintes de disponibilit\u00e9 de l’ACTH) et \u00e9conomiques, la mesure du cortisol basal seul s’est r\u00e9pandue. Un cortisol basal sup\u00e9rieur \u00e0 2 \u00b5g\/dL exclut l’hypoadr\u00e9nocorticisme. En revanche, des valeurs inf\u00e9rieures peuvent s’observer aussi bien dans un vrai Addison que dans de nombreuses autres affections syst\u00e9miques. Le cortisol basal est donc un bon test d’exclusion, pas un test de confirmation.<\/p>\n

Le rapport cortisol\/cr\u00e9atinine urinaires n’avait jusqu’ici gu\u00e8re retenu l’attention des cliniciens, probablement consid\u00e9r\u00e9 a priori comme peu utile et peu pr\u00e9cis. Une difficult\u00e9 pratique s’y ajoute : les chiens en crise addisonienne pr\u00e9sentent souvent un choc hypovol\u00e9mique s\u00e9v\u00e8re avec une diur\u00e8se r\u00e9duite, rendant le recueil d’un \u00e9chantillon urinaire suffisant difficile avant toute fluidoth\u00e9rapie.<\/p>\n

\"\"
Figure 1. Pr\u00e9l\u00e8vement d’urine par cystocent\u00e8se \u00e9choguid\u00e9e chez un chien (avec l’aimable autorisation du Dr Francesco Dondi, Universit\u00e9 de Bologne)<\/figcaption><\/figure>\n

Plusieurs internistes italiens, dont nos consultants en m\u00e9decine interne Magda Gerou Ferriani et Federico Fracassi, en collaboration avec l’\u00e9quipe du laboratoire MYLAV, ont conduit une \u00e9tude publi\u00e9e dans le Journal of Veterinary Internal Medicine<\/em> (Del Baldo et al., 2022).<\/p>\n

Trois groupes ont \u00e9t\u00e9 compar\u00e9s : des chiens sains, des chiens atteints de gastro-ent\u00e9ropathies (dont la pr\u00e9sentation clinique peut ressembler \u00e0 celle de l’hypoadr\u00e9nocorticisme) et des chiens atteints de maladie d’Addison confirm\u00e9e par test de stimulation \u00e0 l’ACTH.<\/p>\n

Les chiens addisoniens pr\u00e9sentaient des valeurs de RCCU tr\u00e8s basses, pratiquement sans chevauchement avec les deux groupes t\u00e9moins. La sensibilit\u00e9 du test s’est r\u00e9v\u00e9l\u00e9e \u00e0 100 %<\/strong>, la sp\u00e9cificit\u00e9 \u00e0 97,3 %<\/strong>.<\/p>\n

Ces performances diagnostiques sont remarquables. Elles devront \u00eatre confirm\u00e9es par des \u00e9tudes sur des effectifs plus larges, mais elles positionnent d’ores et d\u00e9j\u00e0 le RCCU comme un outil plus fiable que la simple mesure du cortisol s\u00e9rique basal et potentiellement tr\u00e8s utile dans les situations o\u00f9 le test de stimulation \u00e0 l’ACTH n’est pas imm\u00e9diatement r\u00e9alisable.<\/p>\n

L’article original est en libre acc\u00e8s : Del Baldo et al., JVIM 2022<\/a><\/p>\n

Walter Bertazzolo<\/strong>, DMV, Sp\u00e9cialiste Europ\u00e9en en Pathologie Clinique V\u00e9t\u00e9rinaire (Dipl. ECVCP) ; Directeur Scientifique de MYLAV<\/p>\n

 <\/p>\n

Picture:\u00a0https:\/\/www.magnific.com\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

La mesure du rapport cortisol\/cr\u00e9atinine urinaires (RCCU) a longtemps \u00e9t\u00e9 n\u00e9glig\u00e9e comme outil diagnostique de […]<\/p>\n","protected":false},"author":3,"featured_media":55296,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[1122],"tags":[],"class_list":["post-55286","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-endocrinologie"],"acf":[],"yoast_head":"\nLe rapport cortisol\/cr\u00e9atinine urinaires dans le diagnostic de la maladie d'Addison chez le chien : un outil plus performant qu'attendu - MyLav<\/title>\n<meta name=\"description\" content=\"D\u00e9couvrez l'int\u00e9r\u00eat du RCCU pour le diagnostic de la maladie d'Addison chez le chien. 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