Immunohistochemistry and polymerase chain reaction on paraffin-embedded material improve the diagnosis of cutaneous leishmaniasis in the Amazon region.

Autor: Amato VS; Infectious and Parasitic Diseases Clinic, Parasitology (LIM 46), Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Avenida Dr. Enéas de Carvalho, São Paulo, Brazil. valdirsa@netpoint.com.br, Tuon FF, de Andrade HF Jr, Bacha H, Pagliari C, Fernandes ER, Duarte MI, Neto VA, Zampieri RA, Floeter-Winter LM, Celeste BJ, Oliveira J, Quiroga MM, Mascheretti M, Boulos M
Jazyk: angličtina
Zdroj: International journal of dermatology [Int J Dermatol] 2009 Oct; Vol. 48 (10), pp. 1091-5.
DOI: 10.1111/j.1365-4632.2009.04099.x
Abstrakt: Background: Recently, there has been an increase in the incidence of cutaneous leishmaniasis (CL), which represents an important health problem. This increase may be related to the epidemiologic expansion of the infective agent and the increase in tourism in tropical areas. The difficulty in clinical diagnosis, mainly in areas in which CL is not the first consideration of local physicians, has intensified efforts to describe diagnostic tests, which should be specific, sensitive, and practical. Amongst the new tests described are those including nucleic acid amplification (polymerase chain reaction, PCR) and immunohistochemistry (IHC).
Methods: In this study, we evaluated the sensitivity of a PCR based on small subunit (SSU) ribosomal DNA, in comparison with IHC using Leishmania spp. antibodies, in biopsies embedded in paraffin.
Result: The results indicated a total sensitivity of 96% (90.9% with PCR and 68.8% with IHC), showing the possibility of using paraffin-embedded biopsies to diagnose CL.
Conclusion: We propose the use of the two tests together as a routine protocol for diagnosis. This would require the provision of local medical services to perform molecular biology techniques and adequate Leishmania antibodies.
Databáze: MEDLINE
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